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PubMed1997

Sudden infant death syndrome and smoking in the United States and Sweden.

The association between sudden infant death syndrome (SIDS) and maternal smoking was compared between the United States and Sweden-two countries with different health care and social support programs and degrees of sociocultural heterogeneity. For 1990-1991 among the five US race/ethnic groups studied, SIDS rates ranged from a high of 3.0 infant deaths per 1,000 live births for American Indians to a low of 0.8 for Hispanics and Asian and Pacific Islanders. The SIDS rate for Sweden (using 1983-1992 data) was 0.9. The strong association between maternal smoking and SIDS persisted after controlling for maternal age and live birth order. Adjusted odds ratios ranged from 1.6 to 2.5 for mothers who smoked 1-9 cigarettes per day during pregnancy (compared with nonsmokers) and from 2.3 to 3.8 for mothers who smoked 10 or more cigarettes per day during pregnancy. Although birth weight had a strong independent effect on SIDS, the addition of birth weight to the models lowered the odds ratios for maternal smoking only slightly, suggesting that the effect of smoking on SIDS is not mediated through birth weight. SIDS rates increased with the amount smoked for all US race/ethnic groups and for Sweden. Smoking is one of the most important preventable risk factors for SIDS, and smoking prevention/intervention programs have the potential to substantially lower SIDS rates in the United States and Sweden and presumably elsewhere as well.

Adolescent↗
PubMed2001

Epidemiology of the reemergence of gonorrhea in Sweden.

BACKGROUND: After many years of decline, the incidence of gonorrhea in Sweden reached an all-time low of 2.4 cases per 100,000 inhabitants in 1996; however, the incidence has been increasing since 1997. GOAL: To describe the reemergence of gonorrhea in Sweden using clinical epidemiologic data and microbiologic characterization of isolated strains of Neisseria gonorrhoeae. STUDY DESIGN: N gonorrhoeae strains isolated in Sweden from February 1998 to January 1999 were serotyped and an epidemiologic data questionnaire was sent to each clinician reporting a case of gonorrhea. RESULTS: Epidemiologic and microbiologic data were obtained for 357 cases (91% of all cases diagnosed during the period). Domestic cases had significantly increased since 1997. Serovar IB-3 was the most common isolate in domestic cases of heterosexually exposed teenagers, and serovar IB-2 was the most frequent isolate in domestic cases of homosexually exposed men. Of the imported cases, 47% were exposed in Asia and 6.5% were exposed in Eastern Europe. CONCLUSION: The increase of gonorrhea in Sweden is due to an increase of domestic cases. Heterosexual teenagers and homosexual men were identified as core groups infected by different serovars of N gonorrhoeae.

Adolescent↗
PubMedDate not supplied

Annual costs of treatment for venous leg ulcers in Sweden and the United Kingdom.

The aim of this study was to estimate costs of treating venous leg ulcers in Sweden and the United Kingdom during 1 year and to quantify costs in different health states. The costs of treating four different types of venous leg ulcers were estimated for 52 weeks by a stochastic health economic model, which simulated resource use data obtained from prospectively collected patient data, expert panels in the two countries, and published scientific literature. The average cost of treating an ulcer varied between 1332 Euro and 2585 Euro in Sweden and from 814 Euro to 1994 Euro in the United Kingdom. Cost of treating large ulcers (>/= 10 cm(2)) of long duration (>/= 6 months) was highest in both countries. Frequency of dressing changes and duration of time for each dressing change were higher in Sweden than in the United Kingdom, resulting in higher total cost per patient in Sweden. An important factor for the total costs was time to heal. Other important variables influencing treatment costs were frequency and duration of dressing changes. Actions to reduce time used for dressing changes and the total time to healing are thus very important in reducing costs spent on treatment of venous leg ulcers in both countries.

Health Care Costs↗
PubMed1995

Reported treatment of hypertension by family physicians in Sweden and Minnesota: a physician survey of practice habits.

OBJECTIVES: To compare family physicians' reported practice habits on hypertension in Sweden and Minnesota, and to assess to what extent different national guidelines account for differences. DESIGN: Random samples of family physicians were selected for telephone interviews on their practice of hypertension. SETTING: Primary care in southern Sweden and in Minnesota. SUBJECTS: Family medicine specialists. Participation rates were 236/264 (89%) in Sweden and 183/209 (88%) in Minnesota. MAIN OUTCOME MEASURES: Cut-off levels, and non-pharmacological and pharmacological treatment of hypertension, related to three case scenarios: a 48-year-old man, a 65-year-old man and a 65-year-old woman. RESULTS: Swedish physicians reported significantly higher levels of diastolic blood pressure than Minnesota physicians for the institution of treatment of hypertension for all case scenarios. In both countries, physicians adhered to the cut-off levels of their national guidelines in the case of the 48-year-old man. Minnesota physicians did not use age as a modifying factor for treatment cut-off levels, as did Swedish physicians. Swedish physicians emphasized alcohol, fat and stress reduction, and Minnesota physicians weight and salt reduction as non-pharmacological treatment. While Swedish physicians generally preferred beta-blockers, Minnesota physicians chose ACE inhibitors or calcium channel blockers as the first choice drug. CONCLUSION: Swedish and US guidelines on hypertension were identical except for higher cut-off level for drug treatment in Sweden. Minnesota physicians reported cut-off levels close to national guidelines. For 65-year-old patients, Swedish physicians reported applying a higher cut-off level than indicated by guidelines. Swedish physicians also reported preferring less expensive drugs. As a consequence of the differing national guidelines and the identified physicians' practice habits in the two medical communities, it is likely that the segments of the populations treated and the drug costs differ substantially.

Adrenergic beta-Antagonists↗
PubMed1988

Diel activity patterns of blood-seeking anthropophilic mosquitoes in central Sweden.

1. Blood-seeking diel activity cycles of mosquitoes are described from 24 h landing catches on human bait in a field and a forest habitat during June-August in central Sweden. 2. Daytime activity in the field was low or absent, whilst in the forest activity was relatively even throughout the diel. 3. In both habitats, activity peaks generally occurred about sunset and sunrise and were more distinct in the field than in the forest. 4. Data from this and other studies show that, in general, Aedes cinereus Meigen feeds at night in field-type habitats and Ae.communis (DeGeer) during the diurnal-crepuscular period in forest and woodland habitats. 5. Although abundant in the study area, Anopheles maculipennis Meigen sensu lato, Culex pipiens L., Cx torrentium Martini and Culiseta morsitans (Theobald) were not caught on the human bait. This is because, in central Sweden, An.maculipennis s.l. is mainly feeding in animal sheds whereas the others are ornithophagous. 6. Ae.geniculatus (Olivier) was recorded from central Sweden for the first time. 7. Blood feeding success (proportion of mosquitoes that managed to obtain blood from the human bait) was significantly greater in Ae.cinereus (14.9%) than in Ae.punctor (Kirby), Ae.communis and Ae.annulipes (Meigen) (2.8-0.7%). 8. The data are interpreted in relation to the transmission of Ockelbo disease (caused by Sindbis virus) and tularaemia in Sweden.

Animals↗
PubMed2005

Lack of mitochondrial DNA divergence between chromosome races of the common shrew, Sorex araneus, in Sweden. Implications for interpreting chromosomal evolution and colonization history.

The common shrew, Sorex araneus, has one of the most variable karyotypes among mammals, displaying numerous chromosome races throughout its distribution. The six chromosome races present in Sweden can be categorized in two different karyotypic groups, the west and north European karyotypic groups (western and northern). Three races belonging to the western group are considered to have arisen through whole arm reciprocal translocations (WARTs). Race formation through this process requires a bottleneck event. In the present study we sequenced a part of the mitochondrial DNA (mtDNA) genome to investigate molecular differences between the chromosome races in Sweden. We found no mtDNA differentiation between the mainland chromosome races or the karyotypic groups. Genetic variation is as large between populations within a race as between populations among the races or karyotypic groups, suggesting that the karyotypic groups might have originated in a common glacial refugium. The noticeable exception is the Oland race, which shows higher mtDNA diversity compared to the other Swedish races, indicating a divergent origin difficult to explain. Mitochondrial DNA variation in Sweden suggests that most haplotypes arose in situ and that the populations has undergone a rapid size expansion. Altogether, the mtDNA data are in agreement with the WART hypothesis, which still holds as the most plausible variant of karyotype evolution for three of the chromosome races of the common shrew in Sweden.

Animals↗
PubMed1999

Cross-cultural adaptation and use of the epilepsy psychosocial effects scale: comparison between the psychosocial effects of chronic epilepsy in Sweden and the United Kingdom.

PURPOSE: To establish Swedish weightings for the Epilepsy Psycho-Social Effects Scale (EPSES) and examine differences between Sweden and the U.K. in attitudes toward chronic epilepsy. METHODS: After translation and back-translation of the EPSES into Swedish, weightings were established through a paired comparison study in which 24 epilepsy professionals participated. The EPSES was then given to a hospital-based sample of 57 patients with chronic epilepsy and the results compared with a British sample matched for age, sex, and frequency of seizures. RESULTS: In the professional judgments of the EPSES statements, there were statistically significant differences in only four of 42 statements. Attitudes to employment, to medication, and to fear of seizures were considered more serious in the U.K., whereas social isolation was considered more a problem in Sweden. Patient attitudes to chronic epilepsy were found to be largely similar in the U.K. and Sweden; however, attitudes to employment, to the future, and to fear of seizures were significantly more a problem for patients in the U.K. CONCLUSIONS: The results indicate a great similarity in the interpretation of problems as measured by the EPSES in the U.K. and in Sweden. The differences in attitudes found are discussed in relation to economic and legislative differences between the two countries. Social as well as cultural differences should be taken into account when using standardized questionnaires. It is suggested that culturally specific weightings should be calculated and that these should be reevaluated at regular intervals.

Adult↗
PubMed1981

Utilization of antiparkinson drugs in Norway, Sweden, Denmark and Finland 1975-1979.

Defined daily doses per day and 10(3) inhabitants [Formula: see text] of the different types of antiparkinson agents have been compared in the period 1975-1979 for Norway, Sweden, Denmark and Finland. A marked increase in the utilization of L-DOPA containing drugs has taken place especially in Sweden following the introduction of the "combined drugs" (L-DOPA + decarboxylase inhibitor). Statistically, nearly all patients with parkinsonism in Sweden have since 1977 been treated with L-DOPA, while in the other nordic countries about 10% of the patients are not on this therapy. These data are discussed in relation to the current concept of pharmacotherapy of parkinsonism. Further, many patients treated with neuroleptic drugs do in addition take anticholinergic agents. Drug utilization figures indicate this method of treatment to be most common in Denmark and Sweden.

Antiparkinson Agents↗
PubMed2005

The ALS/MND prevalence in Sweden estimated by riluzole sales statistics.

OBJECTIVES: To determine whether sales statistics for riluzole can be used as a marker for the prevalence of amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) in Sweden. MATERIALS AND METHODS: A questionnaire was sent to all neurological units in Sweden asking about the numbers of patients with ALS/MND and whether these patients were treated with riluzole. Sales statistics for riluzole were obtained from the 906 public pharmacies and 89 hospital pharmacies in Sweden. RESULTS: Eighty percent of the neurological units answered the questionnaire. The estimated prevalence in September 2003 from the questionnaire was 5.4/100,000 inhabitants. The sales expressed in defined daily dose/100,000 inhabitants/day was 3.8. For the counties the correlation between these two parameters was 0.83. CONCLUSION: Estimated prevalence is highly correlated with sales statistics for riluzole. Riluzole sales statistics could be used as a crude marker for the prevalence of ALS/MND in Sweden.

Adolescent↗
PubMed2006

A multicentre, retrospective study of resource utilization and costs associated with glaucoma management in France and Sweden.

PURPOSE: To assess resource utilization and costs associated with glaucoma management in France and Sweden. METHODS: A total of 267 patient records (121 in France, 146 in Sweden) with diagnoses of primary open-angle glaucoma (POAG) and ocular hypertension (OH), treated medically, were reviewed for a 2-year period (beginning during 1997-99) for relevant clinical and resource utilization data. Economic data were applied to estimate treatment costs. RESULTS: The annual cost of treating glaucoma was estimated at SEK5305 (531 euro )/patient in Sweden and 390 euro/patient in France. In both countries, medication costs comprised about half of the total costs. Surgical procedures and hospitalizations represented greater proportions of total cost in France (7.0% and 9.6%, respectively) than in Sweden (3.7% and 0.6%, respectively). CONCLUSION: Medication costs represent a high proportion of total treatment costs. These findings highlight the relative importance of medical therapy and of assessing the cost-effectiveness of medications in glaucoma.

Aged↗
PubMed1990

Characterization of epidemic and nonepidemic Neisseria meningitidis serogroup A strains from Sudan and Sweden.

A random selection of 25 strains isolated during an epidemic caused by serogroup A Neisseria meningitidis in Sudan (1988), 3 preepidemic meningococcal strains (1985), and 26 serogroup A strains isolated from sporadic cases of meningitis in Sweden (1973 to 1987) were assessed for multilocus enzyme genotypes (ETs), DNA restriction enzyme patterns, outer membrane proteins, lipopolysaccharides, pilus formation, and antibiograms. All of the 25 Sudanese epidemic isolates and 22 of the Swedish strains were of the same or closely related ETs (ETs 3, 4, and 5), corresponding to clone III-1, which has been responsible for two pandemic waves in the last three decades. The earlier pandemic involved Scandinavia, and the last one caused an outbreak during the pilgrimage to Mecca, Saudi Arabia (August 1987), spreading to Sudan, Chad, and Ethiopia. The three Sudanese preepidemic isolates (1985) were clone IV-1 (sulfonamide susceptible), which has been resident in the African meningitis belt for the last 25 years. The uniformity of clone III-1 strains (all sulfonamide resistant) from Sudan and Sweden was confirmed by DNA restriction enzyme patterns. ETs 3, 4, and 5 from Sudan and Sweden had 86 to 100% similarity to a Swedish clone III-1 reference strain, whereas ETs 1, 2, 6, and 7 showed 50 to 80% similarity. Class 1 protein for clone III-1 showed serosubtype antigens P1.9 and P1.x, whereas ET6 strains (clone IV-1) had serosubtype P1.7. Lipopolysaccharides were variable in the Sudanese and Swedish strains. Pili were expressed in all clone III-1 isolates from Sudan and Sweden but in none of the clone IV-1 isolates (Sudan, 1985).

Antigenic Variation↗
PubMed2002

Prehospital thrombolysis: lessons from Sweden and their application to the United Kingdom.

OBJECTIVE: To study the successful implementation of paramedic administered prehospital thrombolysis in Sweden, and to consider the implications of this for the UK. METHODS: A series of research visits were undertaken, including visits to Uppsala Hospital and dispatch centre, ambulance stations in several counties of Sweden and Dalarna County, which has one of the longest experiences of telemedicine supported prehospital thrombolysis in Europe. Data relating to prehospital thrombolysis, stages in successful implementation, and potential barriers to change were identified. RESULTS: Two thirds of the hospitals in Sweden now have some form of prehospital thrombolysis. A nationally agreed and standardised training programme and the fact that many ambulance paramedics are also qualified nurses has facilitated successful introduction, but Sweden's low population density is also an important factor. Data from Dalarna County indicate that the median "pain to needle" time has been reduced by 45 minutes with a concurrent reduction in complications from 50% to 25% (p=0.018). Inhospital mortality has also reduced from 12% to 6%, but with the small numbers involved this improvement does not achieve statistical significance (p=0.36). CONCLUSION: If the outcome of acute myocardial infarction in the United Kingdom is to be improved, and National Service Framework targets met, then prehospital thrombolysis is an important development. Several technical solutions already exist, and a single bolus thrombolytic agent is now available, but the main barriers to full implementation are related to the establishment of an effective training programme and the organisational changes that will facilitate this new practice. High quality research is urgently needed to guide the implementation of prehospital thrombolysis in a clinically and cost effective way.

Delivery of Health Care↗
PubMed1996

Changing life expectancy in the 1980s: why was Denmark different from Sweden?

OBJECTIVE: To identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990. DESIGN: Mortality data from WHO mortality tapes grouped in smaller series of clinically meaningful categories were used to calculate the contribution of each of these categories at each 10 year age group to the difference in life expectancy at birth in each country between 1979 and 1990 and between the two countries. SETTING: Denmark and Sweden. RESULTS: Between 1979 and 1990 life expectancy increased in both Denmark and Sweden. However, the increase in Sweden was more than two years while that in Denmark was less than one year. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy in males as well as females. In both sexes the smaller increase in life expectancy in Denmark was a result of differences in mortality trends in cardiovascular diseases and respiratory and non-respiratory cancers. CONCLUSION: Over a short time two Nordic countries experienced remarkable but different changes in mortality. These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods.

Adolescent↗
PubMed2001

Ethnicity, self reported psychiatric illness, and intake of psychotropic drugs in five ethnic groups in Sweden.

STUDY OBJECTIVE: This study hypothesises that the presumed increased risk of self reported longstanding psychiatric illness and intake of psychotropic drugs among Iranian, Chilean, Turkish, and Kurdish adults, when these groups are compared with Polish adults, can be explained by living alone, poor acculturation, unemployment, and low sense of coherence. DESIGN: Data from a national sample of immigrants/refugees, who were between the ages of 20-44 years old, upon their arrival in Sweden between 1980 and 1989. Unconditional logistic regression was used in the statistical modelling. SETTING: Sweden. PARTICIPANTS: 1059 female and 921 male migrants from Iran, Chile, Turkey, Kurdistan and Poland and a random sample of 3001 Swedes, all between the ages of 27-60 years, were interviewed in 1996 by Statistics Sweden. MAIN RESULTS: Compared with Swedes, all immigrants had an increased risk of self reported longstanding psychiatric illness and for intake of psychotropic drugs, with results for the Kurds being non-significant. Compared with Poles, Iranian and Chilean migrants had an increased risk of psychiatric illness, when seen in relation to a model in which adjustment was made for sex and age. The difference became non-significant for Chileans when marital status was taken into account. After including civil status and knowledge of the Swedish language, the increased risks for intake of psychotropic drugs for Chileans and Iranians disappeared. Living alone, poor knowledge of the Swedish language, non-employment, and low sense of coherence were strong risk factors for self reported longstanding psychiatric illness and for intake of psychotropic drugs. Iranian, Chilean, Turkish and Kurdish immigrants more frequently reported living in segregated neighbourhoods and having a greater desire to leave Sweden than their Polish counterparts. CONCLUSION: Evidence substantiates a strong association between ethnicity and self reported longstanding psychiatric illness, as well as intake of psychotropic drugs. This association is weakened by marital status, acculturation status, employment status, and sense of coherence.

Adult↗
PubMed2000

Implementation of service screening with mammography in Sweden: from pilot study to nationwide programme.

Establishment of mammography screening in Sweden has progressed logically from pilot study through clinical trials to service screening. Screening with mammography for early detection of breast cancer has been provided by all Sweden's 26 county councils since 1997. It took 23 years from the initial pilot study through clinical trials to the establishment of mammography service screening throughout Sweden. In the screening rounds completed by 1995-96, and provided by all but one county council, 1040000 women participated, corresponding to 81% of those invited. The national average recall rate was 2.2%, and consequently 23000 women were recalled for additional investigations. Eleven county councils invited women aged 40-74, six invited women aged 50-69, the remaining eight invited women between both these age intervals. Mammography outside screening programmes-clinical mammography-is available throughout Sweden. About 100000 women a year were referred for clinical mammography and about 50% of these were either younger or older than those invited for screening. A negative relation between the use of clinical mammography and participation in the screening programmes was noticed.

Adult↗
PubMed1997

Epidemiological features of Guillain-Barré syndrome in Sweden, 1978-93.

OBJECTIVES: To describe the incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 and its temporal and geographical variations. METHODS: Stratified and Poisson regression analyses and tests for detection of small epidemics were applied to population based hospital discharge data from 2257 incident cases of Guillain-Barré syndrome in Sweden during the study period. RESULTS: The incidence of Guillain-Barré syndrome was (1) 1.77 per 100000 person-years when age adjusted to the European population; (2) higher in males; and (3) stable across time, although occasional increases of annual incidence rates were found-namely, in 1978 (relative risk (RR) 1.30 (95% CI 1.10-1.54)), and in 1983 (RR 1.24 (95% CI 1.06-1.40)). The incidence increased with age and was bimodal, with peaks at 20-24 and 70-74 years. There was a moderate but significant seasonality with a peak in August, particularly among the young age groups. The age adjusted incidence by county varied from 1.11 to 2.57 per 100000 person-years. Neither temporal nor spatial clustering was significant, except during the period July-September in 1983 at ages below 40 years. CONCLUSIONS: The incidence of Guillain-Barré syndrome in Sweden during the period 1978-93 had a magnitude similar to those described in other surveys, a bimodal distribution by age, and modest geographical and temporal variations with significantly high rates in 1978 and 1983 and in autumn. Minor outbreaks might have passed unnoticed up to the present. Whereas reported drug induced cases of Guillain-Barré syndrome may in part explain the high incidence in 1983, the cause of the aberrant incidence in 1978 remains unknown. Epidemiological surveillance of Guillain-Barré syndrome in Sweden might have been useful.

Adult↗
PubMed1998

Creutzfeldt-Jakob disease in Sweden.

OBJECTIVES: To find and investigate, retrospectively, as many cases as possible of Creutzfeldt-Jakob disease (CJD) in Sweden dying during the period 1 January 1985 to 31 December 1996 and to detect any possible case(s) of new variant CJD. METHODS: The patients were found through computer search of all death certificates in Sweden on which CJD was mentioned, through information from the Swedish neuropathologists, and spontaneous reports from Swedish doctors and hospitals. Data concerning the patients were then collected from patients' case records and from brain histopathology reports. RESULTS: In total 72 cases of spongiform encephalopathy were confirmed as definite by neuropathology, one of them with Gerstmann-Stäussler-Scheinker disease. In 51 further cases there were no brain pathology data but the diagnosis "probable" (37 patients) or "possible" (14 patients) CJD according to WHO criteria could be made on clinical grounds. There was a variation in number of deaths/year, from a minimum of five (1985) to a maximum of 16 (1990). Sixty patients died during the period 1985-90 and 62 during 1991-6. The sex ratio was nearly 1:1. Calculated for a population of 8.6 million (mean of 12 years) in Sweden this gives 1.18/million/year. Age at the time of the presenting symptoms ranged from 34 to 84 years. Only one patient was under 40 at the onset of symptoms. He had a spongiform encephalopathy but prion protein staining was negative. The duration of symptoms that could be attributed to CJD was 6 months or less in 75 cases, 7-12 months in 16 cases, 1 to 2 years in 15 cases, and more than 2 years in 16 patients. By definition all patients were demented. Other more common symptoms and signs were aphasia, dysphasia, dysathria, ataxia, myoclonus, pareses of the extremities, rigidity or spasticity, different types of hyperkinesias, and other psychiatric symptoms (depression, anxiety, and aggressiveness). Less common symptoms were hallucinations (mainly visual), visual defects, sensory symptoms (paraesthesias, itching, or pain), apraxia of swallowing, and disorders of eye movements. CONCLUSIONS: The incidence, the symptomatology, the age distribution (age in years at onset and at death), and the duration of illness were similar to those of other countries except for the cases of new variant CJD in the United Kingdom. There is so far no indication of any cases of new variant CJD in Sweden.

Adult↗
PubMed1997

Injuries after falls at work in the United Kingdom and Sweden with special reference to fractures in women over 45.

OBJECTIVES: To describe the relation with age of risk of reported injury after a fall among women at work in two countries, the United Kingdom and Sweden, with particular emphasis on fractures, and to interpret these data. METHODS: Rates of accidents compiled under the national reporting regulations of each country during a two year period were described by age, sex, cause (fall on the level, fall from a height, other), and occurrence of fracture, with emphasis on the relative risk (RR) in workers aged 45 years and over compared with those aged under 45. For fractures (major fractures only in the United Kingdom) among women, RRs were calculated for all occupations, with the three digit occupational classification schemes of each country. Summary RRs for older versus younger women, directly standardised for occupation, were derived. RESULTS: Among women, RRs for injury after a fall on the level and fall from a height were 2.77 and 1.77 respectively in Sweden and 2.28 and 1.54 in the United Kingdom. When restricted to fractures, the RRs became 4.75 and 3.66 respectively in Sweden and 3.35 and 1.97 in the United Kingdom. Standardisation for occupation gave RRs for fractures of 4.87 and 3.75 in Sweden and 3.43 and 2.16 in the United Kingdom. Almost all occupational groups with enough fractures for analysis showed an excess of fractures related to falls among older women. A different age pattern was seen for all injuries or fracture after other types of accidents and for all types of accident in men. CONCLUSION: It is argued that, for fractures at least, the results for women are unlikely to be due to reporting bias and unlikely to be explained by a greater exposure to workplace hazards among older women. Whether there is an increased risk of falling, as distinct from sustaining a fracture, is not clear. The generality of the increased risk suggest that efforts should be made to minimise hazards in all occupational sectors, particularly those using many women.

Accidental Falls↗