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Exposure to vibrations from tools and machines used in construction work can induce damages to the human body. One of the most frequent symptoms is the hand-arm vibration syndrome commonly known as white fingers. The proportions of the international workforce exposed to vibrations are high and dominating sectors are construction, agriculture, forestry, and transport. Particularly exposed construction occupational groups include machine operators and drivers of vehicles. In 2005, the Swedish Work Environment Authority introduced a new guideline on the topic of preventing vibration exposure risks (AFS 2005:15) based on the European union 2002/44/EC directive on workers' exposure to vibration. It includes raised demands on estimating vibration exposure, and clearly stated responsibilities and rights of employers and employees. However, in 2011 the Swedish Work Environment Authority's inspections showed that many employers belonging to sectors such as building and construction, transport, and mining industry did not have any satisfactory proactive risk management work concerning vibration exposure. This paper reports on a pilot study performed in a large Swedish construction company with the aim to yield more knowledge about factors affecting the implementation of the guidelines and to suggest actions for improvement. A total of 31 construction workers and supervisors were interviewed at nine construction sites in southern Sweden. Interview results demonstrated a lack of knowledge in estimating vibration exposure; the incorporation of the Work Environment Authority's directions had not been accomplished; driving forces for improving the proactive health and safety work and specifically vibration exposure management was weak on all organisational levels; important factors affecting the implementation of vibration exposure regulations are the psychosocial work environment at construction sites as well as company safety culture; a large proportion of the interviewed construction workers was judged to be at risk for developing vibration injuries if the exposure was not decreased; management, supervisory, and production levels need increased knowledge about vibration exposure and vibration injuries; and methods and tools for easy estimation of vibration exposure needs to be developed.

The economic benefits many African countries derive from international
wildlife tourism are very few, especially when viewed from existing
potentials in terms of resources and uniqueness. African wildlife tourism
has natural barriers to entry and thus is basically a monopolistic market.
However, the countries have done virtually nothing to take advantage of
this situation. Rather than focusing on cost recovery or revenue
maximisation, the governments should therefore aim at maximising
profits from international tourism. Uganda is the case study of this paper
in this regard. Data collected from a travel cost survey indicates that in
1997, even under uniform pricing, Ugandan's profit from gorilla
tracking in the Bwindi Impenetrable National Park alone could have
been increased by between USD 30,000 and USD 220,000 (depending
on assumptions about social costs). Besides, unlike most government
revenue sources, monopoly prices on international tourism do not
impose deadweight losses on the domestic economy.

and use and management measures have strong implications on environmental properties such as the quality of soil, water and air, and biodiversity, as well as on social and cultural values. This is also clearly indicated in the Swedish National Environmental Quality Goals where measures to meet quality criteria have been set. However, there are several question marks concerning relations between land management and environment, and in particular there are conflict situations where a specific management form might be positive for the environment in one respect, but negative in another. Although it is not the mandate of science to balance different needs, it is definitely its role to describe the environmental, social and cultural impacts, as well as the economic viability, including the use of environmental and sustainability assessment tools. In this way science enables decisions towards sustainable land use.The environmental, social and cultural impacts from land use might in the future be even bigger as the needs for food, feed, fibre and fuel are supposed to increase substantially. At the same time climate change and loss of natural resources will further limit our ability to meet the demands for food, feed, fibre and fuel. In short, we need to produce more under more difficult circumstances, with less available resources and with less (preferably not any) environmental negative impact. Thus, there is an urgent need to more accurately understand relations between environment and a number of land management measures. Towards this background, the aim of this project was to describe the state of art concerning land management and environment and to elucidate urgent knowledge gaps in order to enable prioritization of further research. The focus is on Swedish conditions, although globalization due to increased global trading and increased global environmental concerns necessitate a certain outlook beyond national boundaries.There is almost an unlimited amount of land use and management varieties. For this reason the study was restricted to some management forms that either concerns a large part of Sweden or, according to the present knowledge, may provide big consequences and/or big uncertainties. It was also restricted to terrestrial land use including wetlands, i.e. the use of water bodies, and fisheries are excluded. Included are complicated questions in forestry such as harvest of biomass in production forestry (c. 60% of all Swedish land), use of harvest residues, cutting forms, nitrogen fertilization, liming, choice of tree species and drained peat-land management. In agriculture we focused on fertilization, liming, cropping systems and tillage and crop-residue management. We decided not to evaluate the use of genetically modified organisms neither in agriculture nor in forestry as the large political and environmental uncertainties involved motivate a report by itself. Finally we also assess methods and consequences for energy forestry and, briefly, for reindeer grazing since about 40% of the Swedish land-area is used for reindeer grazing. If reindeer production is used as an alternative for intensive meat production it will be a measure to decrease emissions of greenhouse gases. Grazing by reindeer affects biodiversity, often positively, especially in areas that suffer from increased abundance of broad-leaved vegetation due to climatic changes. Conflicts are possible in future: the area that is suitable for reindeer grazing may decrease due to a warmer climate, but also due to demands for agricultural development. The report is organized in such a way that the management forms are discussed one by one, followed by a systems perspectives approach. We begin with summarizing conclusions .Systems perspective – How to read figures in the reportFor most chapters in the report there are one or two summarizing figures drawn from an environmental systems perspective. For most options described in the figures there is a reference state given in the figure caption (although not illustrated in the figure). When so, the figure must be read with the reference state in mind as e.g. an increase or decrease in biodiversity depends on that reference state. In the figures, boxes represent activities, and arrows either represent flows, or simply "leads to", when connecting two activity boxes. Green colour signifies avoided activities and related resource use and emissions. Grey colour signifies activities or flows that are likely to be of minor importance in the specific scenario. Oval shapes with dotted boundaries and open arrows at both ends represent activities which life cycles should be included in a systems perspectives for a full picture, but which are either beyond the scope of the report, or link to an earlier figure which is then given. In two figures life cycle data from the CPM (Center for environmental assessment of product and material systems) LCA database, 2011, is included. These date from 2005 and are included to give the reader an idea of the size of resource use and emissions involved.In the summaries below the pictures, the various effects, goal conflicts and the knowledge gaps discussed refer to environmental effects and ecosystem services. Conclusions on economic and social aspects are beyond the scope of this report. Summary and discussionTable 1 is a very condensed summary of the report. It must be read with the comparisons made in mind, i.e. a specific action is not necessarily positive or negative with regard to the chosen parameters generally speaking – only as compared to the reference states used in this report. The effect on climate change is either direct (source or sink of carbon dioxide) or indirect (via a substitution effect). In the case of fossil fuel substitution there is a delay in climate change mitigation; whereas the emission of CO2 from biomass burning is immediate, the uptake of CO2 in the trees that are replacing the cut trees is taking place over decades. Generally speaking, substitution for a construction material is more effective than substitution for fuel. Notably, the table says nothing of the size of the impacts discussed; for this we refer to the special chapters and the literature cited. Neither does the table, nor the report, say anything about how to measure the impact of the different actions. Let alone the report says something about how the various effects can be compared to each other. Most plausible, the answers to these questions will vary from case to case, but also between different actors in the field, depending on what is ascribed the highest importance – or value – in different situations (Haider & Jax 2007). Critical trade-offsIt can be seen from table 1 that many activities that have a positive effect on climate change through a stock or sink mechanism also have positive effects on biodiversity, whereas an increased substitution effect tend to conflict with biodiversity. Similar patterns are there for eutrophication and water regulation (when relevant). These patterns give rise to complex choices as it has to be considered how important harvest of biomass (substitution effect) is as compared to e.g. biodiversity or eutrophication. Except local and case specific aspects – social as well as ecological – there is also a time aspect involved. Our obligations to future generations also needs to be taken into consideration in management of natural resources (de-Shalit 1995; Dobson 1999).Notably, biodiversity, the nitrogen cycle and climate change (in that order) have been pointed out by Rockström et al. (2009) as the three most critical out of nine so called planetary boundaries. Crossing these boundaries is, according to the authors, associated with a risk of deleterious, possibly disastrous consequences for humans. This is pointed out to underline how critical land use measures are, and that the trade-offs between climate change, biodiversity and nitrogen cycle impacts are far from obvious. How do we determine what degree of climate change that corresponds to a given change of biodiversity? It can be argued that increased climate change will in the end affect biodiversity negatively, but on the other hand it can also be argued that higher biodiversity generally means more resilient ecosystems, and more resilient ecosystems cope better with climate changes. A few of the land use measures investigated are positive from climate change point of view as well as from a number of other perspectives. These measures include forest reservation (in the short term), wetland restoration, livestock production with ley (if compared to livestock production with only arable crops), and energy forests (if compared to agriculture). A switch to deciduous tree species may also fall into this category, although here there's a lack of knowledge regarding productivity as well as emissions associated with many tree species. Similarly, certain kinds of selective cutting may be positive from many points of view, but again there are uncertainties with regard to actual emissions. Such (potential) win-win solutions are usually only possible on small areas compared to the area subject to, e.g., conventional forestry, but may be highly significant for the preservation of threatened biodiversity and a number of other ecosystem functions. A national land use strategy aiming for (environmental) win-win options only will however not be possible. Tradeoffs between different environmental values will be necessary. Many of the parameters discussed through the report depend on site specific characteristics. Occurrence of species and site conditions such as soil properties, geology, hydrology, climate, deposition vary from one place to the other. In addition to this, people have different preferences, both at the individual level and at the cultural level. All of this, on top of the scientific difficulty of saying what is "best" when it comes to trade-offs between e.g. climate change and biodiversity, makes it impossible to recommend a "best land management option" on a general level; it will vary from one place to the other and over time, and a variety of options will be needed. A variety of options can be seen as a means of safeguarding a variety of values and ecosystem services, meeting different needs and preferences of people, and as a way of precautious risk spreading. The issue is further complicated when social and economic aspects, in terms of cultural ecosystem services are added. Briefly, cultural ecosystem services are "The non-material benefits people obtain from ecosystems through spiritual enrichment, cognitive development, reflection, recreation, and aesthetic experience, including, e.g., knowledge systems, social relations, and aesthetic values." (Millennium Ecosystem Assessment 2003, p 58). As an example, productivity may be somewhat lower for selective cutting than for clear-cut forestry as well as for deciduous forests compared to spruce stands. On the other hand, selective cutting and deciduous forests may enable cultural, aesthetic and recreational values that production forestry misses. At the same time, it is more plausible that the selective cutting-forests and the deciduous forests enable cultural and recreational activities such as fishing, picking wild berries and hunting. In the case the economic value of these activities is limited (such as in many high-income countries), it is reasonable to include them in the cultural ecosystem services as they contribute to the high cultural, aesthetic, social and health values of a biodiverse landscape (Norling 2001). The cultural ecosystem services are most plausible difficult to replace (Lisberg Jensen 2008). In many cases, then, trade-offs seem to be unavoidable not only between environmental aspects, but also between environmental aspects on the one hand and social and economical aspects on the other, especially if including the global situation in the reasoning (Dobson 2007). In these tradeoffs, science can give advice, but the decisions remain political, and dependent of valuations and preferences. Concerning preferences, there is e.g. a risk that many preferences that people have, are monotonous, short sighted, temporary or just unrealistic to an extent that will challenge environmental decision making, environmental policy and/or environmental ethics (Minteer, Corley & Manning 2004; Minteer &Miller 2011). Furthermore, there is an extensive discussion in environmental ethics about the importance of natural landscapes (Callicott 2001; Hettinger 2002). On the other hand, empirical studies show that naturalness is not crucial. On the contrary, cultivated landscapes obviously have the social, cultural, aesthetic and spiritual values that many people appreciate (Norling 2001).

Målet med denna rapport är att lyfta viktiga frågor som kan säkerställa välfärden hos både häst och människa i hästunderstödda insatser (HUI). Den behandlar hur människors och djurs säkerhet och välfärd interagerar, om patientsäkerhet vid komplementära insatser i vården, elevsäkerhet vid alternativa skolformer samt professionella ställningstaganden rörande mötet mellan häst och människa. Rapporten är ett led i att lyfta fram viktig forskning kring hur vi på bästa sätt kan arbeta tillsammans med hästar i vård, omsorg, psykosocialt arbete och skola. HUI innebär en praktisk tillämpning av One Welfare och One Health koncepten och kan ses som en resurs för att uppnå flera av målen i Agenda 2030. HUI uppstår i skärningspunkten mellan den offentligt finansierade vårdsektorn och landsbygdsutvecklingen. Flera politiska fokusområden berörs när välfärdstjänster inlemmas i hästföretag och alla inblandade individer skall garanteras bästa möjliga hälsa. Djurvälfärd får inte äventyras av orimliga upphandlingsvillkor och människors säkerhet får inte äventyras av företagares bristande kunskaper om hästbeteende eller om funktionsnedsättningars inverkan på förmågan att bedöma risker. I en HUI-verksamhet blir djur en resurs för människors hälsa. Dagens arbetshäst återfinns i ökande omfattning i rehabiliteringsverksamheter och inte enbart för rekreation eller sport. För att utveckla denna växande sektor till en resurs för att möta ohälsoproblem och bidra till rehabilitering och återhämtning behövs en nulägesbeskrivning. Hästar har dokumenterade förutsättningar för att bidra till människors läkande, men kunskapsläget om mekanismerna är oklart. Hästunderstödda insatser är en del av det som kallas "Naturunderstödd rehabilitering", eller "Utomhusrehabilitering". De hälsoeffekter som vistelse utomhus, i naturen, innebär adderas alltid till de specifika effekter som hästens medverkan innebär. Okunskap om hästar och HUI hos upphandlare eller utövare är en stark riskfaktor för människors säkerhet och hästars välfärd. Kartläggningar av branschen 2008 och 2020 visar på en spretig och eldsjälsdriven bransch som förändrats från offentligt bedriven HUI med utövare anställda inom hälso- och sjukvård till mestadels egenföretagare med otrygga avtalsvillkor och korta upphandlingsavtal. Professionerna som erbjuder HUI omfattar nu även professionella inom psykosocialt arbete och inom skolan. Precis som bilden av ohälsa och rehabiliteringsbehov har förändrats mellan 2008 och 2020 har utbudet av tjänster och målgrupper för insatser utvidgats. HUI har ingått i svensk sjukvård oavbrutet sedan dryga 60 år och uppstod som en följd av poliopandemin och de rehabiliteringsbehov som växte fram världen över. I efterdyningarna av dagens pandemi kan HUI utgöra en resurs för personer med långvariga behov av multimodal rehabilitering. HUI karakteriseras av sin omgivande miljö, klientens behov, HUI ansvarigs professionella kompetens och hästens specifika förutsättningar som rörelsegivare, relationsskapare, motivator till deltagande i en insats eller som vän och förebild genom sin sociala kompetens. Användning av djur i terapeutiska sammanhang innebär ett extra ansvar även för djurets välbefinnande under interventionen. Kunskaper om hästens beteende och behov inom inhysning och skötsel samt deras signaler på stress behöver finnas hos alla inom hästnäringen. Detta är en grundläggande djurvälfärdsfråga. Det är viktigt att också HUI ansvariga har denna kunskap så att den kan komma till klinisk nytta och så att hästarnas välfärd inte riskerar att äventyras. Studier tyder på att dålig hästvälfärd och hästar som signalerar ohälsa i sin tur inverkar på klienten på ett ogynnsamt sätt. Dålig hästvälfärd är alltså inte bara en djurskyddsfråga utan blir även kontraproduktiv för HUI verksamheten. Ett identifierat problem inom HUI är de professionellas varierande kunskapsnivå; om hästar, deras grundläggande behov och samspelet mellan hästens välfärd och riskerna för klienterna. HUI ansvarig har en grundprofession inom hälso- och sjukvård, psykosocialt arbete eller pedagogik. Sammanfattning Inom grundprofessionen finns det krav på kompetenser för att utöva yrket men inte för att hantera hästar. Idag saknas ramverk för hur de två sektorerna humansäkerhet och djurskydd skall säkerställas vid HUI. Branschen tog 2009 fram certifieringskrav för HUI ansvariga med särskilt krav på hästkunskap. Då var de flesta ansvariga anställda inom offentlig vård och arbetade tillsammans med en ridskola. Hästkompetens och ansvar för hästvälfärd låg hos ridskolan. Ansvar för klientsäkerhet låg hos sjukvårdshuvudmannen. I dag, med många egenföretagare saknas denna tydliga koppling till existerande kvalitetssystem. Branschen behöver därför utveckla kvalitetssystem för både djurvälfärd och säkerhet. En del i denna process är att upphandlare av HUI tjänster efterfrågar parametrar för såväl hästvälfärd som humansäkerhet. Inget tyder på att HUI innebär större risker för klienten än annan vård. En överblick över incidentrapportering från HUI-insatser internationellt visar på få incidenter. Hästens arbete i HUI är otillräckligt studerat avseende hästvälfärd. En identifierad HUI-specifik situation är att hästen behöver kunna stå still länge på samma plats och behöver tränas att möta olika situationer t ex att ryttare lyfts på från ramp eller via en mekanisk arm. Hästens lämplighet för HUI arbete beror på de krav som insatsen innebär. En lugn häst som terapeuten tycker fungerar väl i insatsen och stabilt byggd om den skall ridas, uppfyller grundläggande krav. Vid HUI observerar, sköter, rider, kör och tränar man hästar. Även besöksverksamhet förekommer. Många verksamheter får hästar donerade, utlånade eller så köper man triangelmärkta eller äldre hästar. Det innebär att hästarnas hälsotillstånd kan variera. Ansvarig måste kunna bedöma individernas olika hälsostatus. Hälsoteam för hästar inom en HUI verksamhet rekommenderas som en strategi för att säkerställa välfärden inom sektorn. Det finns anledning att anta att HUI kan fungera som en positiv välfärdsfaktor för ridskolehästar. Flera HUI verksamheter internationellt har utvecklade samarbeten med djurskyddsorganisationer och fungerar som "Rescue centre" för övergivna hästar. Internationella Etiska riktlinjer för hästvälfärd inom HUI publicerades senast 2021. I dessa förutsätts den ansvarige skaffa erforderliga tillstånd utifrån sin profession och som djuransvarig i enlighet med nationella regelverk. Det finns också anledning att lyfta de etiska principer som styr våra handlingar och diskutera om och hur vi kan rättfärdiga att vi använder djur i vård av människor. En viktig aspekt är att endast då hästen och dess miljö tillför insatsen värden som den professionelle bedömer inte kan uppnås på annat sätt är det etiskt försvarbart att involvera hästen. I rapporten lyfts en modell för etiska aspekter fram. För att kunna utveckla detta område i Sverige föreslås avslutningsvis ett antal rekommendationer till myndigheter och politiker, upphandlare, HUI-företagare och universitet och högskolor.