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- Carlsson, Daniel, 1982-
(författare)
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Effects of cold and hand-arm vibration on the peripheral neurosensory and vascular system : an occupational perspective
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background In Swedish working life, exposure to cold and exposure to hand-arm vibration (HAV) are two common health hazards. Health effects of HAV in the neurosensory, vascular and musculoskeletal systems are collectively denoted hand-arm vibration syndrome (HAVS), and have been thoroughly studied. Effects of cold exposure in terms of effects on the peripheral neurosensory and vascular system are on the contrary limited, especially in an occupational setting. Effects of cold exposure or cold injury have not previously been assessed with quantitative sensory testing (QST). Commonly reported symptoms after exposure to HAV and after cold injuries, includes cold sensitivity and sensation of cold. Cold sensitivity can also occur without previous exposure to vibration or cold and may have a major impact on quality of life. Other possible risk factors for cold sensitivity need to be assessed. Sensation of cold hands could theoretically imply an early manifestation of damage to the neurosensory or vascular system, and therefore be of importance to enable early detection of vascular and neurosensory HAVS. The purpose of this thesis was to increase the knowledge about health effects from cold and HAV on the peripheral neurosensory and vascular system, with an occupational perspective. The aims were: first, to identify and evaluate health effects and sequelae in the peripheral neurosensory and vascular system due to cold injury and cold exposure; second, to investigate if sensation of cold hands is a predictor for future onset of Raynaud's phenomenon or paresthesia; and third, to identify possible risk factors associated with cold sensitivity.Methods A case series on 15 military conscripts with local cold injuries in the hands or feet, involving QST and symptom descriptions, was conducted to investigate the hypothesis that cold injuries can result in similar neurosensory and vascular impairments as in HAVS. To assess health effects of cold exposure, a cohort study on 54 military conscripts in cold winter military training, with cold exposure assessments, was conducted. Possible health effects were assessed after 14 months of military training, containing considerable cold exposure, by means of QST, Finger systolic blood pressure after local cooling (FSBP) and a questionnaire. To investigate if sensation of cold hands is a predictor for vascular or neurosensory HAVS we investigated a cohort of 178 employees at a manufacturing company where HAV was a common exposure. The cohort was followed during 21 years and both vibration exposure and health outcomes were assessed regularly. Questionnaire items were used to assess sensations of cold hands as well as signs of Raynaud’s phenomenon and paresthesia. To identify risk factors for cold sensitivity a case-control study was conducted involving 997iiiparticipants from the general population in northern Sweden. The study was cross-sectional and explored possible risk factors for cold sensitivity.Results Cold injuries and cold exposure were associated with reduced sensibility in QST and increase severity and prevalence of neurosensory and vascular symptoms. Our results did not show any impairment in peripheral blood flow due to cold exposure, detectable by FSBP. The risk of developing Raynaud's phenomenon was increased for workers previously reporting sensation of cold hands (OR 6.3, 95% CI 2.3-17.0). No increased risk for paresthesia in relation to a sensation of cold hands was observed. The identified risk factors for cold sensitivity were frostbite in the hands, rheumatic disease, nerve injury in upper extremities or neck, migraine and vascular disease. When analysing women and men separately, women’s risk factors were frostbite in the hands, rheumatic disease, migraine and cold exposure. Men’s risk factors were frostbite in the hands, vibration exposure and nerve injury in upper extremities or neck. BMI > 25 was a protective factor for both men and women.Conclusion Cold injury and cold exposure are associated with impairments in the neurosensory system, detectable by QST. Symptoms such as sensation of cold hands and white fingers indicate vascular involvement, even though no vascular impairments due to cold exposure could be detected by objective measurements. A sensation of cold hands is a risk factor for development of Raynaud´s phenomenon, but not for paresthesia. At the individual level, reporting cold hands does not appear to be useful information when considering the possibility of a future development of Raynaud’s phenomenon. Frostbite in the hands is a risk factor for cold sensitivity among both women and men. For women rheumatic disease, migraine and cold exposure are also independent risk factors, and for men, exposure to HAV. Being overweight is a protective factor for both women and men.
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| 2. |
- Wahlström Edling, Cecilia, 1959-
(författare)
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Besvär i rörelseorganen hos musiklärare och deras syn på musikelevers hälsa : visioner och verklighet på kollisionskurs
- 2017
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the licentiate thesis was to reach a better understanding of music teachers' health, with focus on musculoskeletal disorders, and music teachers' view on young music students' health, from a gender perspective.A cross-sectional study was directed to music teachers employed at a municipality music- and culture school, in order to investigate the relationship between physical workload and work-related disorders among music teachers. Out of 61 music teachers 47 agreed to participate. The study group was divided into two groups depending on if they had an asymmetric or symmetric upper extremity and back playing posture. Musculoskeletal disorders were frequent among the music teachers. Women music teachers reported significantly more musculoskeletal disorders than their male collegues and music teachers with asymmetric work posture had significantly higher amount of musculoskeletal disorders than those who had a symmetric playing posture.A qualitative interview study with semi-structured interviews with 18 music teachers were conducted to explore music teachers' experiences of health and gender among young music students. An interview guide was used, with topic areas concerning experiences and perceptions of positive health aspects and health problems among young music students, taking part in music education. The interviews were analysed with qualitative content analysis according to Graneheim and Lundman. The analysis resulted in an overarching theme "Visions and reality in contradiction" and three categories: "Music making to feel good", "Pressure on girls, acceptance for boys" and "Blame on the individual".Music teachers at music- and culture schools seem to be at high risk of developing musculoskeletal disorders, especially music teachers playing an instrument that requires an asymmetric playing position. Young musicians' teachers need a better knowledge in the field of prevention of music students' health problems and physiotherapists and ergonomists may assist and collaborate in this. A gender perspective in music medicine research may contribute to a better understanding of musicians' health.
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| 3. |
- Svedmark, Åsa, 1961-
(författare)
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Neck pain in women : effect of tailored treatment and impact of work environment
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Musculoskeletal pain is a common problem in the working population. In Sweden, 40% of women and 30% of men report suffering from neck and shoulder pain weekly. The underlying cause for neck pain is often not known and the treatment is commonly guided by the individual’s symptoms. However, there is a lack of knowledge on how to receive the best effect based on the individual’s symptoms and functional limitations, and therefore this has been scarcely evaluated in research. Furthermore, the impact of work exposure and stress on long-term treatment for persons with neck pain is not clear.Aims: To develop (paper 1) and to evaluate a decision model for tailored treatment in women with neck pain (paper 2). Moreover, to determine if risk factors at work and stress influence intermediate and long-term treatment results (paper 3). Further, to investigate if changes in self-reported pain and disabilities are associated with changes of physical test outcomes of the neck and shoulder region after treatment (paper 4).Methods: In an RCT, 120 working women with non-specific neck pain were randomized to three different groups – tailored treatment (TT), non-tailored treatment (NTT) or treatment-as-usual (TAU) for an 11 weeks intervention with short-term, intermediate-term and long-term follow-ups. The TT group was guided by a decision model with cut-off levels to indicate impairments. The NTT group received two established treatment components randomly from those not indicated, and TAU group did not receive any treatment within the study. The RCT primary outcomes were self-reported neck pain and neck disability. A linear mixed model was used for analysing the effects. One week after the end of intervention work exposure and stress were assessed at a work-place visit and associations to treatment results were tested for, and mixed models were used to estimate longitudinal associations. Associations between self-reported neck problems and physical outcomes were estimated with univariate and multiple regressions analysis.Results: No differences between TT and NTT were revealed for neck pain and disability. In comparison to TAU, the TT and NTT groups both showed improvements at short-term follow-up, but not at intermediate and long-term follow-up. High stress level and low self-estimated control at work were associated with more pain and disability at the intermediate and long-term follow-ups. After intervention and at the intermediate-term follow-up, reduced neck pain, disability and frequency of symptoms were associated with increased peak speed of head rotation and cervical range of motion.Conclusion: Tailored treatment according to the decision model was not superior to the non-tailored treatment in women with non-specific neck pain. One explanation for this can be the weak relationships found between neck pain and disability and physical test outcomes. Further, perceived stress and psychosocial work exposure were associated with self-reported neck problems and should be taken into account to optimize the effects in neck pain rehabilitation.
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| 5. |
- Riva, Gabriele, et al.
(författare)
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A CFD study of a pin-on-disc tribometer setup focusing on airborne particle sampling efficiency
- 2017
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Ingår i: ECOTRIB 2017.
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Konferensbidrag (refereegranskat)abstract
- One of the most important measures to evaluate air quality is the presence of particles. Pin-on-disc tribometers are used to study airborne wear particles originating from different sliding contacts in a controlled laboratory environment. One important aspect when measuring airborne particles is to ensure isokinetic sampling conditions. Another important aspect is that the concentration and the particles distribution entering the sampling probe are representative for the emissions generated. It is therefore important to have an estimation of the sampling efficiency of the test system. The aim of this paper is to investigate the particle sampling efficiency of a pin-on-disc tribometer setup. In addition, a modified sampling setup that allows isokinetic sampling is investigated. CFD simulations to investigate air and particle motion were performed for both the existing and the modified configuration. The results show that the velocity field at the outlet does not allow isokinetic sampling for the existing configuration. In the modified configuration a sampling pipe is used to make isokinetic sampling possible. A comparison between the two configurations show that the modified configuration increases the sampling efficiency with almost 40% for ultrafine particles and about 20% for fine and coarse particles. It remains to validate the CFD simulations with experiments.
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