In the Nordic work environment model, health risks at work are mainly to be managed in cooperation with the employees and their representatives. The model is based on strong trade unions and is supported by the state through participatory rights and funding to produce and disseminate knowledge on risks and solutions. The model is evident in the large Swedish municipal sector with its strong unions and extensive social dialogue. However, municipal employees also face widespread risks, mainly from mental and physical overload. They led the costly wave of rising sickness absence from the late 1990s. Municipal (and other) employers therefore attempt to reduce the absence. The rural municipality of Leksand started a project H?lsosam with the broad objectives to half the absence, implement a national agreement on better dialogue, make Leksand an attractive employer, and improve employee influence and work environment. The article?s objective is to use H?lsosam?s intervention project to explore the limits of what the Nordic work environment model can achieve against risks rooted in the employers? prerogative of organizing, resourcing, and managing the operations that create the conditions at work. H?lsosam?s practice focused on sickness absence and the forms of the new national agreement. The absence was halved by reducing cases of long-term sickness. There was also workplace health promotion and the safety reps were supported through regular meetings. However, little was done to the extensive mental and physical overload revealed in a survey. Nor was the mandatory work environment management improved, as was ordered by the municipal council. This remained delegated to first-line managers who had a limited ability to handle work risks. This limited practice implemented Leksand?s political priority to reduce the absenteeism, while other objectives had less political support. The difficulties to improve the work environment and its management were as demonstrated by other research on municipalities? limited development capacity. H?lsosam?s narrow focus was also supported by the limited priorities of the national municipal employers. This gave a narrow perspective in the central social partners? consultants to Leksand and other municipalities. H?lsosam thereby demonstrates both the strengths and the weaknesses of the Nordic work environment model. On the one hand, the local dialogue was even further improved. On the other, local and central trade union cooperation with the employers did not enable them to much raise the organizational problems of work overload and poor work environment management. Leksand?s municipal employees remained squeezed between limited taxes and unlimited service demands and had to ?solve? this by too hard work.
