In Sweden, municipalities and counties are among the largest employers, with more than a million employees out of Sweden 9 million inhabitants. Sweden is divided into 20 county councils which include four regions which are further divided in 290 municipalities. They are self-governing local authorities; municipalities are responsible for matters relating to the inhabitants of the municipality and the main task of the county councils and regions is healthcare. According to the Swedish work environment act, the employer is responsible for occupational health and safety. Employers are required to cooperate with employees and safety representatives about the work environment and occupational health- and safety management (OHSM). If necessary, the employer is required to consult and use support from external resources as occupational health services provider (OHS) (Swedish Work Environment Authority, 2015). The use of OHS as an expert resource in OHSM is hence strategically important for the prevention of work-related ill-health and accidents. In municipalities and counties the services can be provided by an in-house OHS unit or be purchased from a private OHS provider. The purpose of this study was to identify conditions and key factors for successful collaboration and use of OHS providers’ services in municipalities and counties, leading to preventive and proactive OHSM. Our results demonstrate how a good dialogue between employer, employees and OHS is a key factor for establishing effective use of expert knowledge and support. However, our study found only few cases where the OHSM actors – including managers, participating workers and their safety reps – have a significant role in defining the aims and scope of OHS support. One main finding was that OHS were only to a limited extent consulted on preventive issues. OHS was to a larger extent utilized for reactive tasks, such as rehab, and for curative services, as well as for activities that focused on individual health, such as health promotion e.g. non-smoking programs. Hence, OHSM actors had limited access to expert support from OHS to find, investigate and abate work environment risks. Many human resource (HR) departments have been transformed from being administrative support functions into being strategic business partners within the organizations. In our study, HR were in most cases main contract counterpart to OHS, heading the process for procurement and following up costs and delivered services. This means that HR, representing the management, had a major impact on provided support and services and the interaction with OHS. This jeopardizes the independent and neutral role of OHS. It also resulted in managers as well as workers and safety reps perceiving OHS as a HR resource, ant not as a resource for their local OHSM. The HR task in OHSM was in most cases focused on sick leave and rehab. Hence, the utilization of OHS became focused on individual issues as rehabilitation, curative services and wellness activities. Even though our study shows that public organizations have well established formal structures and rather extensive dialogue between managers and workers/safety reps on OHS issues, there is a lack of interaction and dialogue with OHS about work, workplace risks, causes and solutions. As a consequence, access to OHS support in and about preventive OHSM was limited, both for managers and for safety reps and workers. From this follows that OHS also have limited access to the actual workplaces, and to local knowledge, experiences, activities and discussions on health and safety. Utilization of OHS as an expert resource in preventive OHSM is thus restricted and inefficient This report is only available in Swedish.
IVL Svenska Miljöinstitutet, 2015.