Under covid-19-pandemins första våg, tidigt våren 2020, valde de flesta länder, inklusive Sverige, att rekommendera eller kräva att de anställda som kunde skulle arbeta på distans från bostaden för att minska smittspridningen på arbetsplatser och under resor till och från dessa arbetsplatser. Att arbeta på distans skiljer sig i många avseenden från att arbeta i arbetsgivarens lokaler.

Det övergripande syftet med denna översikt, som består av tre delar, har varit att sammanställa och öka den forskningsbaserade kunskapen om distansarbete i hemmet.

Översikten omfattar forskningslitteratur inom tre områden:

• arbetsmiljö och hälsa
• balans mellan arbetsliv och privatliv
• produktivitet.

I analyserna har vi därtill särskilt fokuserat på likheter och skillnader i mäns och kvinnors villkor vid lönearbete i hemmet. Ytterligare syften har varit att undersöka och dra slutsatser om distansarbete i hemmet under tiden före respektive under pandemin.

During the first wave of the COVID-19 pandemic in early spring 2020, most countries, including Sweden, chose to recommend or require employees for whom doing so was possible to work remotely from home in order to reduce the spread of infection at workplaces, and during commutes to and from workplaces. Working remotely differs in many respects from working at theemployer’s premises. The overall objective of this three-part review has been to compile and increase research-based knowledge of remote work from home.

This review encompasses research literature in three areas:

• work environment and health
• work–life balance
• productivity.

In the analyses, we have therefore focused in particular on similarities and differences in the conditions for men and women regarding paid work at home. Additional aims were to investigate and draw conclusions about remote work from home during the period before and during the pandemic, respectively.

The first part is a review of research reviews of remote work before the pandemic (published 2005–2021), while the second part is a review of original studies of remote work from home during the pandemic (2020– 2021). Part three comments on and summarises the material presented in parts one and two. The main purpose of the division into before and after is that remote work before the pandemic was primarily voluntary and planned, while remote work from home during the pandemic was unexpected, with minimal planning, and more or less forced.

The review has been limited to remote work from home conducted by employees through an internet connection.

This work analyzes the different levels of salivary cortisol in women from the southwest of Spain that were victims of intimate partner violence (IPV) with respect to a control group, assessing for the first time the different concentrations obtained in relation to a worldwide reference standard provided by the CIRCORT meta-global cortisol database. The clinical sample (N = 24) and the control group (N = 25) had an average of 39.12 years (SD = 12.31) and 39.52 years (SD = 11.74), respectively. Cortisol awakening response (CAR) was determined by defining the area under the curve (AUCi). There were no differences between the CAR data of the two populations F (1, 141) = 1.690, p = 0.196, but there was a highly significant difference in the three sampling days, where the clinical sample exceeded the cortisol levels of the CIRCORT database in the evening as compared to the control group (p = 0.004, p = 0.001 and p = 0.000). Salivary cortisol concentration samples taken in the evening were significantly higher than those standardized in the CIRCORT database, from the women victims of IPV as compared to the control group, showing its usefulness as an effective supportive tool for problems such as those triggered by IPV.

Rehabilitering och samordning, Rehsam, var ett forskningsprogram som initierades av regeringen år 2009. Målet var att öka den evidensbaserade kunskapsmassan kring rehabilitering av personer som är sjukskrivna, eller riskerar att bli sjukskrivna, på grund av psykiska eller muskuloskeletala problem. Denna rapport är en sammanfattande utvärdering av Rehsamprogrammet.

Som en uppföljning av Rehsam-satsningen fick Forte 2014 bland annat i uppdrag att göra en vetenskaplig kvalitetsbedömning av den forskning som genomförts inom Rehsam-satsningen. Detta uppdrag har genomförts i olika etapper, med två delrapporter under 2015. Den här utvärderingen omfattar 21 projekt och är en slutrapport av uppdraget.

Sammanfattningsvis visar Rehsam-projektens resultat att projekt som omfattar insatser på arbetsplatsen är mer effektiva än de projekt som inte genomfört arbetsplats-interventioner. Tendensen är även att projekt med högre vetenskaplig kvalitet oftare har signifikanta utfall.

Contextual factors including neighborhood status have consistently been associated with health disparities. This may relate to a poorer neighborhood status involving an exposure to chronic stressors, which dysregulates cortisol secretion. This study investigated single and aggregate cortisol measures in 88 working women living in high and low status neighborhoods. Results showed significantly lower waking cortisol among women in low status neighborhoods. However, there were no group differences in aggregate cortisol measures. The lower morning cortisol among women in the low status neighborhoods follows previous research suggesting hypocortisolism as a pathway linking neighborhood status and health disparities, albeit a less consistent finding across cortisol measures in this sample. This may relate to the Swedish welfare state and its fostering of equality.

The Swedish Council on Health Technology Assessment (SBU) conducted a systematic literature review of research on the association between occupational exposures and back disorders. In this review, we use back disorders as an umbrella term to include the more specific terms back trouble (a subjective experience of pain, ache or discomfort in the back), symptoms of sciatica, intervertebral disc changes and diseases of the back. The report is focused on disorders of the thoracic and lumbar spine. A wide range of occupational exposures were investigated, including: physical work load, vibration, organizational and psychosocial factors, chemical and biological factors, noise, environmental factors and contagious substances.

Background: Since 2011 SBU has had a mandate from the Swedish government to systematically assess the evidence associating occupational exposures to health issues. The objective of this review was to assess the scientific basis describing the influence of occupational exposures on back disorders. Back disorders are common. Between 60 and 70 percent of the general population world-wide suffer from back pain at least once in their life. For affected individuals, back disorders are the source of both suffering and decreased functioning. The costs to society are also considerable in terms of direct health care costs, financial support to individuals with work disability, as well as costs due to loss of production.

Method: A systematic review was undertaken following the PRISMA statement and standard methods used by SBU adapted to an occupational context. A literature search covering years 1980 to January 2014 was conducted in international medical and occupational data bases. The review assessed almost 8 000 abstracts. Studies that fulfilled strict inclusion criteria were assessed for relevance and quality, using pre-set protocols. Relevance and quality assessments were conducted by two experts, working in an evaluation pair. After conducting independent assessments, the two experts had to agree on a mutual relevance and quality classification. Some articles required that all exporters participated in discussion and made a collective assessment. A total of 109 studies were classified as moderate or high quality, representing more than 150 000 study participants. The strength of the scientific evidence was assessed with the GRADE system.

Results: There is an association between occupational exposure and back disorders. This result is based on investigations of a large variety of work environments, mainly in Europe and North America. In most studies passing the quality criteria, researchers investigated occupational exposure and back disorders in populations consisting of both women and men with at least one year of follow up.

Conclusions: People in the following groups develop more back trouble over time than those who are not subjected to the specified exposure at work:

– Those who work with manual handling (e.g. lift) or in a posture where the back is bent or rotated

– Those who work in a kneeling or squatting posture, or have physically demanding work tasks

– Those exposed to whole body vibration

– Those who experience work as mentally stressful; or those who find their work demanding, but lack decision latitude (personal control of their own working situation); or those who have insufficient opportunities for personal development

– Those who work outside standard office hours.

In some work environments, people have less back trouble. Those who experience high influence over work-related decisions, those who get social support at work and those with high job satisfaction develop less back trouble than others.

Women and men with similar occupational exposures develop back troubles to the same extent.

Those who work in forward bent postures or are exposed to whole body vibration in their work develop more symptoms of sciatica than others, while those with high job satisfaction develop less such symptoms. Those whose work entails manual handling develop more intervertebral disc changes than others.

This systematic literature review has uncovered a substantial body of knowledge concerning occupational exposures and back disorders. Future research should include intervention studies, i.e. studies that scientifically test the effect of well defined interventions on back disorders over extended periods of time in authentic work situations.

Project group

Experts: Karin Harms-Ringdahl (Chair), Sven Ove Hanson (Ethics), Olle Hägg, Ulf Lundberg, Svend Erik Mathiasen, Gunnevi Sundelin, Magnus Svartengren, and Hans Tropp.

SBU: Charlotte Hall (Project Director), Karin Stenström (Assistant Project Director), Agneta Brolund (Information Specialist), Therese Kedebring (Project Administrator), Laura Lintamo (Investigator), Maria Skogholm (Project Administrator), Lena Wallgren (Scientific Writer)

Scientific reviewers: Eva Denison, Mats Hagberg, Gunnar Nemeth, Esa-Pekka Takala.

Stressrelaterad ohälsa svarar för en stor del av sjukfrånvaron i Sverige och medför således omfattande kostnader för samhället och stort lidande för dem som drabbas. I denna artikel beskrivs vilka faktorer i det moderna samhället som bidrar till ökad stressbelastning och vad som händer i kroppen som kan förklara olika stressrelaterade hälsoproblem, både psykiska och fysiska, hos kvinnor och män. Vidare beskrivs vanliga stressymtom och möjligheter att förebygga dessa.

Objectives: To investigate heart rate variability (HRV) in fibromyalgia (FM) patients and healthy controls (HCs) during different sleep stages, and to examine the association of HRV with pain and sleep quality.

Method: Polysomnography was recorded from 23 female FM patients and 22 age- and sex-matched HCs. HRV was recorded from bedtime until awakening including the standard deviation of normal-to-normal intervals (SDNN), the root mean square successive difference (RMSSD), and the low (LF; 0.04–0.15 Hz) and high (HF; 0.15–0.4 Hz) frequency power. Subjective scores of neck/shoulder pain and sleep quality were obtained at bedtime and awakening.

Results: Both patients and HCs showed high incidence of arousals per hour (FM: 16 ± 9.7; HCs: 17 ± 11). RMSSD was lower in patients than HCs during non-rapid eye movement (non-REM) stage 2 (N2) sleep (mean ± SD; 30 ± 12 ms vs. 42 ± 13 ms, p < 0.002) and during REM sleep (23 ± 11 ms vs. 37 ± 16 ms, p < 0.003). HRV did not differ between groups during N3 sleep (p > 0.19 for all comparisons). In patients, SDNN, RMSSD, and HF power showed modest positive correlations with sleep quality (HF power during N3 sleep showed the highest correlation; Spearman’s ρ = 0.54) and modest negative correlations with neck/shoulder pain (RMSSD during N3 sleep showed the highest correlation with pain at bedtime; Spearman’s ρ = –0.51).

Conclusions: RMSSD, indicative of parasympathetic predominance, is attenuated in FM patients compared to HCs during N2 sleep and REM sleep. This difference was not present for the HF component. HRV during sleep in FM patients is moderately and positively associated with sleep quality and moderately and negatively associated with neck/shoulder pain

Om boken på förlagets hemsida: Stora grupper av människor riskerar idag att drabbas av social jetlag - att leva i ett tomrum där de är fysiskt uppkopplade men inte socialt, emotionellt och intellektuellt upplever ett sammanhang. Nytt i denna upplaga är beskrivningen av strategier för att motverka detta och för att öka vår egen och arbetslivets motståndskraft mot stress. Här presenteras både beprövade och helt nya metoder för en effektiv stressbehandling på individ-, grupp-, organisations- och samhällsnivå.