| 1. |
- Stjernbrandt, Albin, et al.
(författare)
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Occupational cold exposure and symptoms of carpal tunnel syndrome : a population-based study
- 2022
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).METHODS: In this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Cold exposure and presence of symptoms suggestive of CTS were subjectively reported. Associations between exposure and outcome were evaluated using logistic regression.RESULTS: The study included 2,703 women and 2,314 men, with a median age of 60 years (interquartile range 19). Symptoms of CTS were reported by 453 (9.2%). Being highly occupationally exposed (almost always) to contact cooling of the hands was associated with reporting CTS (OR 3.20; 95% CI 1.62-6.33), as was ambient cooling (OR 2.00; 95% CI 1.03-3.88) and severe ambient cooling (OR 4.02 95% CI 2.09-7.71), after adjusting for age, gender, body mass index, current daily smoking, diabetes mellitus, joint disease, and hand-arm vibration exposure. The point estimates increased with longer daily exposure duration. For workers exposed to severe ambient cooling for more than half of their working hours, in addition to performing heavy manual handling every day, the OR for reporting CTS was 7.25 (95% CI 3.88-13.53), with a positive additive interaction effect (expressed as relative excess risk due to interaction) of 4.67.CONCLUSIONS: Self-reported occupational exposure to contact and ambient cooling was associated with symptoms suggestive of CTS. There were statistically significant positive exposure-response patterns for time spent exposed to contact and ambient cooling at work in relation to reporting symptoms of CTS. Positive additive interaction effects between cold exposure and heavy manual handling were also found. Since there was important potential uncontrolled confounding regarding repetitive wrist movements and forceful gripping, the results need to be confirmed by other studies, preferably with longitudinal design and more detailed exposure assessment.
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| 2. |
- Stjernbrandt, Albin, et al.
(författare)
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Occupational cold exposure is associated with upper extremity pain
- 2023
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Ingår i: Frontiers in Pain Research. - : Frontiers Media S.A.. - 2673-561X. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Occupational cold exposure is common in Sweden but potential impacts on musculoskeletal disorders have not been thoroughly investigated. The primary aim of this study was to determine the associations between occupational contact and ambient cooling in relation to pain in the upper extremity.Methods: In this cross-sectional study, a digital survey was conducted on a population-based sample of women and men between 24 and 76 years of age, living in northern Sweden. Occupational cold exposure, heavy manual handling, work with vibrating tools as well as the presence of upper extremity pain at different sites were subjectively reported. Associations between exposure and outcome were evaluated using multiple binary logistic regression.Results: The final study sample included 2,089 (54.4%) women and 1,754 men, with a mean age of 56 years. Hand pain was reported by 196 (5.2%), lower arm pain by 144 (3.8%), and upper arm pain by 451 (11.9%). Severe ambient cooling for more than half of the working time was statistically significantly associated with hand pain (OR: 2.30; 95% CI: 1.23–4.29) and upper arm pain (OR: 1.57; 95% CI: 1.00–2.47) but not lower arm pain (OR: 1.87; 95% CI: 0.96–3.65) after adjusting for gender, age, body mass index, current daily smoking, heavy manual handling, and work with vibrating tools.Conclusions: Occupational cold exposure was statistically significantly associated with hand pain and upper arm pain. Therefore, occupational cold exposure should be recognized as a potential risk factor for musculoskeletal disorders in the upper extremity.
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| 3. |
- Burström, Lage, 1954-, et al.
(författare)
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White fingers, cold environment, and vibration : exposure among Swedish construction workers
- 2010
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 36:6, s. 509-513
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to examine the association between white fingers, cold environment, and exposure to hand–arm vibration (HAV). The hypothesis was that working in cold climate increases the risk of white fingers.Methods The occurrence of white fingers was investigated as a cross-sectional study in a cohort of Swedish male construction workers (N=134 757). Exposure to HAV was based on a job-exposure matrix. Living in the north or south of Sweden was, in a subgroup of the cohort, used as an indicator of the exposure to cold environment (ie, living in the north meant a higher exposure to cold climate). The analyses were adjusted for age and use of nicotine products (smoking and snuff).Results HAV-exposed workers living in a colder climate had a higher risk for white fingers than those living in a warmer climate [odds ratio (OR) 1.71, 95% confidence interval (95% CI) 1.42–2.06]. As expected, we found that HAV-exposed workers had an increased risk compared to controls (OR 2.02, 95% CI 1.75–2.34). The risk for white fingers increased with increased level of exposure to HAV and also age.Conclusions Cold environment increases the risk for white fingers in workers occupationally exposed to HAV. The results underscore the need to keep exposure to HAV at workplaces as low as possible especially in cold climate.
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| 4. |
- Carlsson, Daniel, 1982-, et al.
(författare)
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Can sensation of cold hands predict Raynaud's phenomenon or paraesthesia?
- 2018
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Ingår i: Occupational Medicine. - : Oxford University Press (OUP). - 0962-7480 .- 1471-8405. ; 68:5, s. 314-319
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Tidskriftsartikel (refereegranskat)abstract
- Background Raynaud's phenomenon and neurosensory symptoms are common after hand-arm vibration exposure. Knowledge of early signs of vibration injuries is needed. Aims To investigate the risk of developing Raynaud's phenomenon and paraesthesia in relation to sensation of cold hands in a cohort of male employees at an engineering plant. Methods We followed a cohort of male manual and office workers at an engineering plant in Sweden for 21 years. At baseline (1987 and 1992) and each follow-up (1992, 1997, 2002, 2008), we assessed sensation of cold, Raynaud's phenomenon and paraesthesia in the hands using questionnaires and measured vibration exposure. We calculated risk estimates with univariate and multiple logistic regression analyses and adjusted for vibration exposure and tobacco usage. Results There were 241 study participants. During the study period, 21 individuals developed Raynaud's phenomenon and 43 developed paraesthesia. When adjusting the risk of developing Raynaud's phenomenon for vibration exposure and tobacco use, the odds ratios were between 6.0 and 6.3 (95% CI 2.2-17.0). We observed no increased risk for paraesthesia in relation to a sensation of cold hands. Conclusions A sensation of cold hands was a risk factor for Raynaud's phenomenon. At the individual level, reporting a sensation of cold hands did not appear to be useful information to predict future development of Raynaud's phenomenon given a weak to moderate predictive value. For paraesthesia, the sensation of cold was not a risk factor and there was no predictive value at the individual level.
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| 5. |
- Carlsson, Daniel, et al.
(författare)
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Neurosensory and vascular function after 14 months of military training comprising cold winter conditions
- 2016
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian journal of work, environment & health. - 0355-3140 .- 1795-990X. ; 42:1, s. 61-70
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study aimed to examine the effects of 14 months of military training comprising cold winter conditions on neurosensory and vascular function in the hands and feet.METHODS: Military conscripts (N=54) were assessed with quantitative sensory testing comprising touch, temperature, and vibration perception thresholds and finger systolic blood pressure (FSBP) after local cooling and a questionnaire on neurosensory and vascular symptoms at both baseline and follow-up. Ambient air temperature was recorded with body worn temperature loggers.RESULTS: The subjects showed reduced sensitivity to perception of touch, warmth, cold and vibrations in both the hands and feet except from vibrotactile perception in digit two of the right hand (right dig 2). Cold sensations, white fingers, and pain/discomfort when exposed to cold as well as pain increased in both prevalence and severity. There were no statistically significant changes in FSBP after local cooling.CONCLUSION: Fourteen months of winter military training comprising cold winter conditions reduced sensation from touch, warmth, cold, and vibrotactile stimulus in both hands and feet and increased the severity and prevalence of symptoms and pain. The vascular function in the hands, measured by FSBP after local cooling, was not affected.
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| 6. |
- Eklöf, Mats, et al.
(författare)
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Workplace intervention for improved risk perception and preventive activity among workers : using hand-held vibrating machines: a pilot study
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This article presents a pilot study of a 1-h workplace educational intervention implemented among ten construction workers who were highly exposed to hand–arm vibration. The intervention combined risk communication and normative expert advice intended to reinforce preventive behaviour related to vibration, noise, and biomechanical loads. Data for this study comprised intervention notes and interview data from interventionists, and pre- and post-intervention interview data from participating workers.The results suggested that the intervention was sensitive to disturbances and should be directed only to motivated workers possessing sufficient self-efficacy, and only in circumstances in which exposure may be controlled on the local workplace level and by locally implemented measures. Unless these conditions are present, the studied intervention may fail to influence preventive behaviour, and may instead cause cognitive dissonance and frustration among participants and interventionists.
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| 7. |
- Jackson, Jennie A, et al.
(författare)
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Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers
- 2019
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 45:1, s. 63-72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE).Methods: A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971–1993) were examined prospectively over a 13-year case ascertainment period (2001–2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register.Results: There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18–1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers.Conclusion: Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.
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| 8. |
- Jackson, Jennie, et al.
(författare)
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Biomechanical risk factors for surgically treated ulnar nerve entrapment in a cohort of Swedish male construction workers
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The literature on occupational risk factors for ulnar nerve entrapment (UNE), also called cubital tunnel syndrome is sparse.Objectives: The aim was study the association between occupational biomechanical exposures and UNE.Methods: The occurrence of UNE was examined prospectively in a cohort of 229 689 Swedish male construction workers who participated in a nation-wide occupational health surveillance program between 1971 and 1996. UNE case status was defined on the basis of a surgical release of ulnar nerve entrapment; case data were obtained from a national outpatient database for a 13 year observation period (2001-2013). Individual risk factors considered were smoking status, BMI and age. Biomechanical exposure estimates were assigned at the occupational group level using a job exposure matrix developed specifically for the study and included 10 ergonomic (force/posture/repetition) and 2 hand-arm vibration exposure parameters determined a priori to be relevant to UNE. Relative risks (RR) for all biomechanical factors were modelled using negative binomial regression analyses and adjusted for age, smoking habits and BMI.Results: There were 555 cases of surgically treated UNE in the cohort and the average annual incidence was 19.2 cases per 100,000 person-years. Smoking status (ever vs. never smoker RR=1.28, 95% CI=1.07-1.54) and BMI (≥25 kg/m2 vs. < 25 kg/m2 RR=1.60 , 95% CI=1.34-1.91) were associated with increased risk of UNE. Increased grip force (RR=1.54, 95% CI =1.24-1.92), hand-Arm-vibration (RR=1.35, 95% CI=1.07-1.71) upper extremity load (RR=1.63, 95% CI=1.30-1.92), and increased frequency of hand tool use (RR =1.37, 95% CI=1.09-1.71), elbow flexion and extension (RR=1.36, 95% CI=1.10-1.68), and static work (RR=1.36, 95% CI=1.12-1.65) were also associated with increased risk of UNE.Discussion and Conclusions: Our findings demonstrate that multiple biomechanical factors were associated with increased risk of UNE. Many of the identified risk factors involved elevated hand grip force (grip force, upper extremity load, and frequency of hand tool use and hand-arm vibration) which may indicate it is a key etiological aspect of UNE.
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| 9. |
- Jackson, Jennie, et al.
(författare)
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Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers
- 2019
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Ingår i: Occupational and Environmental Medicine. - : BMJ Publishing Group. - 1351-0711 .- 1470-7926. ; 76:5, s. 326-331
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period. Methods A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships. Results The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00). Conclusions Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.
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| 10. |
- Jackson, Jennie, et al.
(författare)
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Occupational risk factors for hospitalization due to cervical disc disorder in a 29-year prospective study of Swedish male construction workers
- 2019
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Ingår i: PREMUS 2019. ; , s. 168-168
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The aim of this study was to assess the associations between individual and occupational exposure factors and hospitalization for cervical disc disorder (CDD).Methods: CDD was examined prospectively in a cohort of 278 319 Swedish male construction workers who participated in a national health surveillance program (1971-1993). Job title, smoking status, age, height, and weight were recorded on examination. Case data were obtained through linkage with the Swedish national in-patient hospital registry for the period 1987 – 2016; case status was defined by primary diagnosis code M50.0 (ICD-10) or 722.0, 722.4, or 722.7 (ICD-9). A job exposure matrix was developed and occupational exposure estimates were assigned by job title. Self-reported estimates of pain/discomfort from a subset of 87 500 workers were also linked to the database. Poisson regression models were used to estimate the relative risks (RR) for the biomechanical and self-reported factors with adjustment for smoking status, age, BMI and surgical time period.Results: There were 562 cases of hospitalization for CDD; the incidence rate was 8.0 cases per 100 000 during the 29-year follow-up period. Smoking status, age, BMI and height were all associated with increased risk (RR 1.21-3.16). Occupational exposure to static work in non-neutral or extreme neck postures, and time spent in awkward postures showed the highest associations with CDD hospitalization (RR = 1.62 – 2.10). Upper arm load and time with arms above shoulders were also associated with increased risk (RR = 1.50 – 1.58). Workers who reported experiencing pain ‘often’ or ‘very often’ during the previous year for any of the neck, shoulder or upper back regions had a 3-fold increase in risk relative to workers reporting no pain.Conclusions: Occupational non-neutral neck posture was associated with increased risk of hospitalization for CDD. Our data also suggest an exposure-response relationship for self-reported neck pain/discomfort and risk of hospitalization for CDD.
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