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Research into the detection and prevention of exposure to chemicals has a long history in Sweden. Carin Håkansta gives a brief overview of the policy context that enabled this type of OSH research to prosper, how policies have changed over time and how those changes affected the area. Furthermore, she describes how Swedish research on chemical exposures has developed through time. Finally, in order to give a flavour of research today, three examples of ongoing research projects funded by FAS in the area of chemical risks are presented.
The rise and fall of OSH in Swedish research policy
Political radicalisation in the late 1960s and early 1970s caused policy changes in most OECD countries, both in the area of research and in the labour market area. Research and education policies came under pressure from within academia as well as from the outside to change the focus from what was perceived as ‘ivory tower science’ to ‘useful’ research with the aspired purpose of problem solving.
In parallel to the pressure against academic conservatism, labour market policies in many countries including Sweden were under fire for allowing inhumane working conditions. There was also a debate around labour relations, which were perceived by the trade unions and the left wing political parties to be undemocratic in the favour of the employers, not the employees.
Several large strikes in Sweden in the early 1970s resulted in an increased political focus on occupational health issues and workplace democracy, resulting in agreement between the government, trade unions and employers’ organisations that improvements of working conditions were needed. This agreement led to new legislation as well as increased resources to work related research.
Swedish research policies of the 1970s were beneficial to OSH research in several ways. Firstly, higher education was substantially expanded. Several new universities were established, leading to additional research environments. Secondly, the amount of available government funding for research in general was scaled up. Thirdly, and most importantly, the type of funding that was given priority was ‘sectoral research’, e.g. science with a focus on problem solving and a close relationship between scientists and the practitioners, e.g. occupational health services.
The various government ministries were given research budgets with the purpose of funding research benefitting their sector. OSH research, being a prominent area for the Ministry of Labour and supported by the social partners, benefitted substantially from this policy. The creation of the Swedish Work Environment Fund in 1972, financed through a levy on the payrolls, played a key role in the build up of a strong cadre of Swedish OSH researchers in the 1970s and 1980s. The Fund financed research as well as information, training and education in the area of OSH.
Changing political winds in the OECD (Organisation for Economic Co-operation and Development) in the 1980s and 1990s also affected Sweden, causing research policies as well as labour market policies to change. Rather than favouring problem solving research, research policies shifted priority to sectors of strategic importance to the nation. For work related research, the policy change led focus to shift to ways to enhance productivity and away from working conditions. The amount of government funding available to OSH research was gradually reduced in the 1990s, mainly due to reorganisations of the research funding organisations and government institutes.
Another change that affected OSH research was emerging disagreement between the social partners. During the 1970s and 1980s, the social partners had been very influential in government institutions, especially related to the labour market, through their presence on the governing boards. Because of disagreements, which were particularly difficult during discussions on co-determination in the 1970s, the employers’ organisations eventually withdrew from the boards of government institutions in the early 1990s. The trade unions subsequently lost their seats too.
In 2001, the government dismantled what was left of state support to sectoral research. The budget of the successor to the Work Environment Fund (the Council for Working Life Research) was divided into two parts. One part was allocated to Vinnova, a new organisation created to support research collaboration between academia and enterprises. The other part was allocated to the Swedish Council for Working Life and Social Sciences (FAS), which in many ways continued the tradition of previous organisations funding work related research.
The difference between FAS and its predecessors, however, is that rather than being a problem and user driven, sectoral research funding organisation, FAS is a ‘traditional’ research council, built on the principle of peer review, allowing researchers to sit on the managing board and in the committees deciding on research funding.
Research on chemical protection in Sweden
In the late 1970s and 1980s, university departments of occupational medicine and occupational dermatology were established at universities and regional hospitals. Starting in the 1980s, these clinics gradually received a regional responsibility to examine individual patients and to carry out research.
Personnel at the OSH clinics were also given the responsibility to visit workplaces and promote preventive activities. The trade union interest in the issue and employers’ readiness to cooperate resulted in a system that was very fruitful for creative research on the association between exposures and disease. Another feature of Swedish OSH research was the creation of criteria groups for the documentation of the scientific basis for occupational exposure limits and methods for exposure measurements. A Swedish as well as a Scandinavian criteria group was established. A third feature of importance to the development of Swedish OSH research was the establishment, next to the university departments and OSH clinics, of a national OSH institute. The origin of this institute was a small department of occupational hygiene at the National Swedish Institute of Public Health, founded in 1937. The department subsequently became an independent institute, which grew large and prestigious in the 1970s and 1980s, when it doubled in size to 300 employees. In 1995 the institute merged with the smaller Centre for Working Life, an institute that dealt with more controversial issues such as workplace democracy and the implementation of the Swedish law of co-determination. The creation of the National Institute for Working Life thus led to a fusion of different types of work related research. At the same time, funding was reduced and there was a change in focus, leading to more research on psychosocial issues and less on chemical and physical factors. The institute was abolished in 2007. Swedish research in occupational dermatology had developed already in the 1960s through a combination of competence in medicine, analytical chemistry and occupational hygiene. This, from an international perspective, unusual and successful multidisciplinary research collaboration was possible thanks to the emergence of OSH clinics. The clinics became bridges between researchers at the university and practitioners at hospitals and workplaces. In the area of chemical protection, associations were explored between chemical risk factors and allergic contact eczema and new methods of testing the skin and the sensitising properties and chemicals were developed. The detection of contact allergens, for instance in epoxy-resins systems, led to successful primary prevention efforts, including technical changes and changes in workplace practises. The assessment of skin exposure subsequently improved through the development of various biomarkers with which exposures could be measured. As already mentioned, Swedish OSH research experienced a substantial expansion in the 1970s due to a combination of increased resources, the collaboration between epidemiology and occupational hygiene and the availability of new and sensitive analytical instruments. Analytical methods with lower limits of detection made it possible to improve air-sampling methods, leading to research on exposures related to welding, organic solvents, pesticides, polychlorinated biphenyls (PCB), asbestos, synthetic mineral fibres, jet fuel, cadmium and lead, metal smelting plants and diesel exhaust in the mining industry. Improvements in the assessment of dermal exposures, especially those caused by epoxy compounds, led to new research on mould, asphalt work, electromagnetic fields, vibration, polyester-resin lamination and ventilation. Occupational epidemiology in Sweden has long benefitted from reliable population registries in combination with registries of deaths, tumours, malformations and diagnoses for hospital patients. These registries greatly facilitated the development of epidemiological methods, making possible a number of studies on cancer and causes of death. Perhaps the most significant and symbolic accomplishment of Swedish research into chemical exposures was the case of asbestos. In the 1970s, the views of what was acceptable risk in general and asbestos in particular changed dramatically. Large surveys in asbestos-cement factories and other industries using asbestos for insulation, such as shipyards, were carried out by the OSH clinics. Many workers were found with radiographic changes in the lung and pleura, decreased lung function and even respiratory failure, causing death. The attention given to the risks of asbestos in Sweden led to practically total prohibition of its use and several nations to follow the Swedish example, although the use of asbestos still is allowed in many countries.
Applying research findings practically
While successful application of research findings hinge on close collaboration with other agencies, such as between scientists and workplace managers, governments or labour organisations, this is not where communication concludes. Research findings also have an impact on future safe practice. A good example of such an area is asbestos, in which research has led to recommendations for the wearing of Personal Protective Equipment (PPE) such as protective suits, gloves and Respiratory Protective Equipment when disposing of the substance. Similarly, research into how workers handle pesticides, or chemicals such as brominated flame retardants, also have an impact on how employers calculate workplace hazards – and corresponding methods to eliminate or control these hazards.
Examples of ongoing research
The purpose of the presented projects below is to give a flavour of what goes on in the Swedish research on chemical protection today. One interesting workplace for research is the airplane, and an ongoing project is studying exposures to brominated flame retardants for personnel working in aircraft. The aim of the project is to measure the presence of different types of brominated flame retardants in settled dust in the cockpit and cabin, as well as in the serum of 105 persons, including pilots, cabin crew and maintenance workers. The participants are asked to answer a questionnaire on work, leisure activities and eating habits. The maintenance workers are furthermore going through dust sampling and personal exposure measurement before and after cleaning the aircraft. The purpose of the project is to establish exposure levels. If they are found to be high, this would stimulate the search for alternative methods of fire protection. A second example of research is in the area of exposure to pesticides in greenhouses. Urine samples are collected from 50 workers involved in the growing of vegetables and ornamental plants. The samples are then analysed for existing and new pesticide biomarkers. In addition, an occupational hygienist makes observations and skin exposures are measured through pad technique. An information and prevention campaign will subsequently be carried out, after which urine samples are collected again. Results will be disseminated to the scientific community as well as the relevant branches. The third and last example of ongoing research is an investigation into whether occupational exposure limits are an effective tool for chemical risk management at the workplace. A comparison is made between Sweden and the Netherlands, a country with a higher degree of self-regulating than Sweden. Written studies and interviews on the regulatory processes are made in the two countries as well as interviews and surveys in workplaces in Sweden and the Netherlands. Chemical risks differ from physical risks due to the longer time between exposure and adverse effects, which affects how risks are perceived and communicated. By investigating the use of occupational exposure limits, the research team intends to identify regulatory, social and organisational factors that can contribute to more efficient management of chemical risks. The identification of factors that affect risk perception is expected to improve communication within companies as well as between authorities and companies.
Conclusion
In the 1970s and 1980s, Swedish occupational health research grew strong, also in international comparison. This strength was due to beneficial trends in the research policies as well as strong support from the government and the social partners, resulting in the establishment of research funding at a high and stable level and a growing cadre of competent researchers. It was not, however, only the available financial resources and political support that made Swedish OSH research thrive. Of great importance was also the close collaboration between occupational hygienists and epidemiologists, and the availability and easy access to excellent registries on diseases and deaths in the Swedish population. Another important factor was the establishment of hospital-university clinics in every region of Sweden, where researchers and workplace practitioners could meet. The early detection and subsequent ban on asbestos is a prime example of this kind of collaboration. Shifts in government research policy priorities and weakening political support for OSH research since the 1990s have caused available research funding to shrink, not least through the close down of the National Institute for Working Life in 2007. The closure of the institute and reduction in funding has caused worries about the future of Swedish OSH research. An analysis made by FAS in 2006, however, showed that Swedish OSH researchers still perform at an internationally high level and FAS still receives approximately the same number of applications for project grants in the area as it did ten years ago. Among the between ten and 20 OSH proposals funded by FAS each year, many projects address chemical protection. Methods to detect exposures are continually developed and refined, exposure levels in specific branches are analysed and new methods in how to improve the prevention to exposures are developed.
Published: 04th Jul 2012 in Health and Safety International
