Comparison of Danish and Swedish national occupational injury statistics shows that the reported LTI-rate, or number of reported lost-time injuries per million working hours, for Danish construction workers is significantly higher than the reported LTI-rate for Swedish construction workers. In terms of injury prevention it is important to identify injury risk factors that contribute to the observed differences in LTI-rates. In the present Oresund Link case study Danish and Swedish workers worked in cross-national work gangs, carried out the same types of tasks and utilized the same reporting procedures for occupational injuries. Thus, factors that usually confound comparisons between countries were eliminated in this study. Furthermore, factors at company level were to a great extent excluded in the study design, which therefore provided a unique opportunity to investigate the importance of injury risk factors at group and individual level for Danish and Swedish workers. LTI-rates and injury risk factors were compared for Danish and Swedish workers during the construction of the combined rail and road link across the 16-km wide sound, Oresund, between Denmark and Sweden. The comparison showed that the LTI-rate of the Danish construction workers was approximately fourfold the LTI-rate of the Swedish construction workers. Factors at the micro-level (group and individual level) e.g. differences in education and experience, training and learning, and attitude were important for the explanation of the significant difference in LTI-rates between Danish and Swedish construction workers. The study also indicated that comparison of national data on LTI-rates should be carried out with great caution. (C) 2003 Elsevier Science Ltd. All rights reserved.