The top manager at the Swedish Work Environment Authority was "uncomfortable" with the expert's conclusion about mouth guards

SVT's review of how the Swedish Work Environment Authority has handled the matter with the mouth guards at the Serafen nursing home has created strong reactions.

- Confidence in the Swedish Work Environment Authority as an independent expert authority is damaged, says Marina Tuutma, chairman of the Swedish District Medical Association to SVT.

Following the formal conclusion of the Serafen case, the authority has now published a large number of documents showing how the internal discussion went.

It appears that the crack inside the walls was very deep, and not only about the issue but also about the handling. Among other things, a manager receives harsh criticism for refusing to record her conversations with the employer, the city of Stockholm.

The management believes that it is not necessary because it did not add anything to the matter, but one employee thinks it "is under all criticism and also terribly inappropriate".

The email also shows how the management wanted to change the authority's position before the Serafen case would go to court, and not pursue the requirement for oral protection as a minimum level, but focus on local risk assessments. One manager describes it as "a certain correction of our original decision".

The management also chose not to include the conclusion reached by the authority's own medical expert, that only a visor does not protect against infection.

"I am uncomfortable with such an absolute conclusion," writes one of the authority's top executives. "We have had discussions with other authorities about how we relate to FHM's recommendations and we always say that they are the starting point and that a risk assessment should be made in the individual case." The boss also refers to the fact that this would be closer to how one has expressed oneself in the media.

The expert asks: "Hand on heart, would you voluntarily go to a seriously ill patient with coronavirus, sit at the patient's bed, hold the patient's hand, and talk to the patient, with only a plastic disc for the face."

The Swedish Work Environment Authority's acting head of inspection, Peter Burman, does not want to comment on the email in detail with reference to the authority sending a report to the Ombudsman reviewing the handling. But he says that the email expresses an internal disagreement in the face of an unknown virus.

See SVT's review of the oral protection dispute.