Table 4.

Occupational accidents and work-related illness among young Nordic apprentice workers

Author, (Year)	Data source, population	Industry gender	Exposure	Effect	Results	Study design and quality
Occupational accidents among young Nordic apprentice workers (N = 4)
Holte & Kjestveit (2012) Norway	Convenience sampling. Interviews with 11 construction workers/apprentices (aged 18–23 years) and four other levels—coworker, supervisor, manager, & safety deputy.	Construction apprentices. No gender given.	Company size	Initial OSH training and introductory courses Formal vs informal training. Mentors	Large companies, more formalized systems and structures. Smaller companies, more “learning by doing” and external courses. Interpretations: OSH legislative differences based on company size. Recommendations: Specific requirements for OSH training of new/young workers. Establish standards for use of mentors—and a joint education and certification of mentors	Interviews Qualitative 12/20 = 60%
Kjestveit et al (2011) Norway	Convenience sampling. Construction industry. 456 respondents (98 % response rate). 30% of respondents = aged 18–24 years No gender given.		Age, company size, and profession. Safety climate and work factors.	Injury involvement in the last 6 months—“stop working for one hour or more”	Young workers have a higher risk of injury (controlled for company size and profession). Physical work demands (heavy lifting, vibrations, etc.) & control over work pace—associated with increased injury risk. Safety climate not associated with increased injury risk. Need for focus on the distribution of work tasks	Cross-sectional survey. Validity: Internal 15/29 = 52% External 6/8 = 75%
Nielsen (2012) Denmark	Five focus group interviews with 4–5 people from different workplaces. In total, 23 employees/apprentices employed in retail, industrial work, hotel, and restaurants were interviewed (aged 15–24 years).	Retail industry and apprentices	Examines the organizational relations among youth and risks.	“Accidents” How safety is experienced and practiced among young employees	Young employers risk behavior does not stem from a desire for risk-orientated work, but it is rather a way to fit in, to adapt, and to master the conditions of the trade. The risk behavior in the young employees often reflects the risk culture in the organization. Youth and risk-taking can be linked to the constructions of: “acceptable risk” and “organizational deviances.”	Focus group interviews Qualitative 9/20 = 45%
Nielsen et al (2013) Denmark	Single and group interviews with 26 young adult workers from 6 various sized supermarkets (aged 18–24 years).	Retail industry N = 5 apprentices	Apprentices and other groups of young workers	How safety and risk are experienced and practiced	Apprentices do not regard themselves as “young risk-taking workers.” The apprentice talks about adapting to what is recognized as the “right way” to practice risk and safety from the perspective of the manager. Apprentices are typically trying to live up to the demands of the manager, e.g., even though the apprentice knows that it implies taking risks.	Focus-group interviews Qualitative 16/20 = 80%
Work-related illness among young Nordic apprentice workers (N = 14)
Bregnhøj et al (2011) A Denmark	Hairdressing apprentices (n = 382) and control group (n = 1870) mean age 17.5 years. Enrollment in the period 2008–2009.		Hairdressing (2 weeks into training).	Hand eczema	Significantly fewer hairdressers reported hand and arm wrist eczema than control group from the general population. Results indicate a healthy worker effect among the hairdressing apprentices.	Cross-sectional study Validity: Internal 16/26 = 62% External 6/8 = 75%
Bregnhøj et al (2011) B Denmark	Hairdressing apprentices (n = 382) and control group (n = 1870) mean age 17.5 years. Enrollment in the period 2008–2009.		Exposure to chemical substances both at work and at leisure (hair dyes and perfumed products)	Adverse skin reactions (rash and eczema)	The hairdressing apprentices are more exposed to the allergens investigated and report more adverse reactions to products containing hair dyes than their matched controls. Regulations of exposure need to be considered to prevent primary sensitization and elicitation. Young hairdressing apprentices need information concerning the potential risk of extensive exposure to chemical substances.	Cross-sectional study Validity: Internal 16/26 = 62% External 6/8 = 75%
Bregnhøj et al (2012) Denmark	Hairdressing apprentices (n = 502) mean age 17.5 years. Intervention group vs. control group. Baseline, 8-month, 18-month follow-up.		Exposure to chemical substances in the hairdressing profession	The intervention was based on educating the teachers in training schools (2-day course of special training in skin physiology, allergy, and skin protection.)	More apprentices from the intervention group used gloves during wet work procedures and significantly fewer developed hand eczema than apprentices in the control group. The study shows that evidence-based education may be an effective approach for the prevention of occupation hand eczema among hairdressing apprentices.	Intervention study Validity: Internal 28/45 = 62% External 8/8 = 75%
Dahlin et al (2010) Sweden	Junior doctors followed up from medical school (2002 and 2005) and first year of work (2003 and 2006). (n = 253) At follow-up, mean age was 27.4 years.		Factors at medical school (higher Education Stress Inventory and performance self-esteem)	The exhaustion dimension of burnout at work (Oldenburg-Burnout Inventory)	Worries about future capacity predicted postgraduate exhaustion. A positive learning climate was negatively associated with exhaustion. No difference in exhaustion by gender when controlled for study conditions	Prospective study Validity:Internal 25/39 = 64% External 4/8 = 50%
Hagberg et al (2005) Sweden	Musician students enrolled at the University of Göthenburg between 1980 and 1995 n = 407). Mean age of men = 35 years; mean age of women = 34 years.		Instrument type, instrument years, practice for >20 h per week.	Impaired hearing, tinnitus, and musculoskeletal disorders	Association between the number of hours of instrumental practice and impaired hearing. There was more than 2 times higher incidence of MSD in the wrist, hand, and elbow of musicians who practiced for 20 h or more per week than those with less practice. The incidence of tinnitus was 10.6 1000 practicing years, impaired hearing was 6.5 1000 practicing years, and musculoskeletal disorders was 2.3–4.6 1000 practicing years. Female gender was a risk factor for low back pain and elbow/forearm pain.	Cross-sectional study Validity: Internal 15/26 = 58% External 5/8=63%
Hanvold et al (2010) Norway	173 technical school students aged 16-21 Males 34%, females 66% 13 schools.		Mechanical exposure	Neck, shoulder, upper-back pain stress	High prevalence of any pain (female 78%, male 47%), fewer report moderate/severe pain (female 32%, male 14%). High and moderate level of mechanical exposure and high stress were not risk factors for pain. High leisure physical activity associated with lower risk for pain. Experiencing pain in adolescence can persist into working life. Uncertainty about factors leading to musculoskeletal pain. Females reports more neck and shoulder pain than men.	Prospective study Validity: Internal 26/39 = 67% External 7/8 = 88%
Hanvold et al (2013) Norway	40 young technical students aged 21-25 Male 42%, female 58% Electricians, hairdressers, various work & students.		Sustained trapezius muscle activity (>4 minutes for more than half of the working day)	Neck and shoulder pain	High level of sustained muscle activity have higher rates (x3) of pain compared to low levels of muscle activity. No recommendations. Gender difference in pain (female).	Prospective study Validity: Internal 27/39 = 69% External 2/8 = 25%
Held et al (2001) Denmark	Sample of n = 107 student auxiliary nurses (n = 61 intervention group, n = 46 in control group). Follow-up after 10 weeks of practical training.		Intervention included an educational programme (class a 2 × 2 h course with an interval of 14 days. Included an information video and a booklet.	Clinical examination by a doctor on hand eczema/skin irritation. Transepidermal water loss (TEWL) and patch testing was also used	The use of hand disinfectants were significantly lower in the intervention group. The use of hand disinfectant agents was found significantly associated with aggravation of skin problems. A significant increase on TEWL for the control group was found. The intervention shows promising results from the use of an educational programme.	Intervention study Validity: Internal 19/45 = 42% External 4/8 = 50%
Skjold et al (2007) Denmark	Female and male baker apprentices (n = 187, mean age 22). Recruited in 1998-199 and followed over a 3 year period		Occupational baker exposures (i.e. flour dust)	Respiratory symptoms and atopy/allergy	The prevalence of atopy and lung symptoms was of the same magnitude as the general population. Atopy prevalence 32%, lung symptoms 20%	Cross-sectional study Validity: Internal 18/26 = 63% External 5/8 = 63%
Omland et al (1999) Denmark	Female faming students (n = 210 mean age 19), male farming students (n = 1691, mean age 18) and male controls (n = 407 mean age 18).		Occupational farming exposure	Lung function (FEV1 and FVC) and Lung symptoms (self-reported asthma	No association was found between occupational farming exposure at a young age and lung symptoms or lung function	Cross-sectional study Validity: Internal 21/26 = 81% External 7/8 = 88%
Sigsgaard et al (1997) Denmark	Female farming students (n = 230 mean age 19.7), male farming student s(n = 1734 mean age 18) and male controls (n = 407 mean age 18.5)		Occupational farming exposure	Respiratory symptoms and atopy/ allergy	The prevalence of atopy and lung symptoms was of the same magnitude as the general population. Atopy prevalence 32%, lung symptoms 20%	Cross-sectional study Validity: Internal 18/26 = 63% External 5/8 = 63%
Skjold et al (2008) Denmark	Female and male baker apprentices (n = 114, mean age 23) Followed over a 20 month period.		Occupational baker exposures (allergens i.e. flour dust)	Respiratory symptoms and allergic sensitization	Rhinitis and asthma-like symptoms were found to develop commonly in Danish baker apprentices. Sensitization to occupational allergens was rarely observed.	Prospective study Validity: Internal 25/39 = 64% External 5/8 = 63%
Svensson et al (2009) Denmark	Female nursing assistants students (n = 668) were randomized into intervention group (n = 389, mean age 32) and control group (n = 279, mean age 33).		Intervention: Low back prevention programme; physical training (48 h), patient transfer technique training (20 h), stress management (22 h).	Sickness absence during the last 14 days (at baseline and at 14 months follow-up).	Sickness absence increased in both groups but the increase was significantly lower in the intervention group. No significant difference in the prevalence of low back pain at follow-up was found between the two groups. The results suggest that introducing prevention programs in the curriculum may be beneficial.	Intervention study Validity: Internal 27/45 = 60% External 8/8 = 100%
Videman et al (2005) Finland	Female nursing students (n = 174, mean age 22) were followed over a 7.5 years (2.5 years in school and 5 years in nursing profession).		Physical loading and psychological characteristics	Back pain and disability	Lifetime prevalence of back pain increased sharply during nursing school and back pain in school was a strong predictor for back pain and related disability as a nurse. Working in twisted and bent postures was associated with back pain and related disability as a nurse. The high prevalence of back pain before entering nursing and the irregular nature of back pain suggest that symptoms may well be exacerbated during nursing.	Prospective study Validity: Internal 27/39 = 69% External 6/8 = 75%

MSD, musculoskeletal disorder; OSH, occupational safety and health.