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Pettersson, H., Olsson, D. & Järvholm, B. (2020). Occupational exposure to noise and cold environment and the risk of death due to myocardial infarction and stroke. International Archives of Occupational and Environmental Health
Open this publication in new window or tab >>Occupational exposure to noise and cold environment and the risk of death due to myocardial infarction and stroke
2020 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: The present study examined a possible association between occupational exposure to noise, working and living in cold conditions, and the risk of mortality in myocardial infarction and stroke.

METHODS: The present cohort study consists of 194,501 workers in the Swedish construction industry that participated in health examinations between 1971 and 1993. Noise exposure was defined on a job-exposure matrix based on a survey of the working conditions carried out during the mid 1970s. All workers were categorised into three main regions of Sweden, differing in temperature: Reference (Götaland), colder (Svealand), and coldest (Norrland). Relative risks (RR) were analysed by negative binomial regression adjusting for age, BMI, and smoking habits.

RESULTS: Moderate and high noise exposure was associated with increased risk of myocardial infarction (RR 1.10-1.13 with 95% CI over unit) and stroke mortality (RR 1.15 to 1.19 with 95% CI over unit). There was an increased risk for myocardial infarction (RR 1.10, 95% CI 1.01-1.20), but not for stroke mortality (RR 1.09, 95% CI 0.94-1.25) associated with living and working in the coldest region. There was an interaction on the risk of myocardial infarction mortality between different regions and noise exposure (p = 0.016), but not for stroke mortality (p = 0.88).

CONCLUSIONS: The study indicates an interaction between working at hazardous noise levels and living and working in cold conditions for increased mortality in myocardial infarction.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Cerebrovascular disease, Ischemic heart disease, Mortality, Prospective cohort study, Work environment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-167217 (URN)10.1007/s00420-019-01513-5 (DOI)31915923 (PubMedID)
Funder
AFA Insurance, 150070
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2020-01-14
Stjernbrandt, A., Pettersson, H., Liljelind, I., Nilsson, T. & Wahlström, J. (2019). Raynaud's phenomenon in Northern Sweden: a population-based nested case-control study. Rheumatology International, 39(2), 265-275
Open this publication in new window or tab >>Raynaud's phenomenon in Northern Sweden: a population-based nested case-control study
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2019 (English)In: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 39, no 2, p. 265-275Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to determine the association between individual and external exposure factors, and the reporting of Raynaud’s phenomenon, with or without concomitant cold sensitivity. In a population-based nested case–control study, cases with Raynaud’s phenomenon (N = 578), and matched controls (N = 1156), were asked to respond to a questionnaire focusing on different risk factors. Univariate and multiple conditional logistic regression were performed. Analyses were stratified according to whether the cases reported cold sensitivity or not. In total, 1400 out of 1734 study subjects answered the questionnaire (response rate 80.7%). In the final multiple model, the factor with the strongest association to Raynaud’s phenomenon, with and without cold sensitivity, was previous frostbite affecting the hands (OR 12.44; 95% CI 5.84–26.52 and OR 4.01; 95% CI 1.78–9.01, respectively). Upper extremity nerve injury was associated to reporting Raynaud’s phenomenon and cold sensitivity (OR 2.23; 95% CI 1.29–3.85), but not Raynaud’s phenomenon alone. Reporting any exposure to hand-arm vibration or cumulative cold exposure was significant in univariate analyses for cases with both Raynaud’s phenomenon and cold sensitivity, but not in the multiple model. Raynaud’s phenomenon is strongly associated to previous cold injury, with a larger effect size among those who also report cold sensitivity. The fact that only upper extremity nerve injury differed significantly between case groups in our multiple model offers additional support to the neural basis for cold sensitivity.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Cold exposure, Epidemiology, Frostbite, Hand, Occupational exposure, Risk factors
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152083 (URN)10.1007/s00296-018-4133-y (DOI)000457425100009 ()30128730 (PubMedID)
Funder
Västerbotten County Council, VLL-646641
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2019-02-20Bibliographically approved
Carlsson, D., Wahlström, J., Burström, L., Hagberg, M., Lundström, R., Pettersson, H. & Nilsson, T. (2018). Can sensation of cold hands predict Raynaud’s phenomenon or paresthesia?. Occupational Medicine, 68(5), 314-319
Open this publication in new window or tab >>Can sensation of cold hands predict Raynaud’s phenomenon or paresthesia?
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2018 (English)In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 68, no 5, p. 314-319Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
Hand-arm vibration, hand-arm vibration syndrome, Raynaud's phenomenon, paresthesia, sensation of cold
National Category
Occupational Health and Environmental Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-141012 (URN)10.1093/occmed/kqy053 (DOI)000439653500005 ()
Note

Originally published in thesis in manuscript form.

Available from: 2017-10-20 Created: 2017-10-20 Last updated: 2018-11-01Bibliographically approved
Stjernbrandt, A., Carlsson, D., Pettersson, H., Liljelind, I., Nilsson, T. & Wahlström, J. (2018). Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden. International Archives of Occupational and Environmental Health, 91(7), 785-797
Open this publication in new window or tab >>Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden
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2018 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 7, p. 785-797Article in journal (Refereed) Published
Abstract [en]

Aim To identify possible risk factors for cold sensitivity, by comparing cases to controls with regard to demographic and anthropometric characteristics, previous illnesses and injuries as well as ambient exposures.

Methods Through a questionnaire responded to by the general population (n=12,627) cold sensitivity cases (n=502) and matched controls (n=1,004) were identified and asked to respond to a second questionnaire with focus on different aspects of cold sensitivity, hereditary factors, previous diseases, medication, tobacco use as well as exposure to ambient cold climate and hand-arm vibration (HAV).

Results In total, 997 out of 1506 study subjects answered the second questionnaire, 374 cases and 623 match controls. Identified risk factors among the cases were frostbite of the hands Odds Ratio (OR) 10.3 (95% confidence interval (CI) 5.5-19.3), rheumatic disease OR 3.1 (95% CI 1.7-5.7), upper extremity nerve injury OR 2.0 (95% CI 1.3-3.0), and vascular disease OR 1.9 (95% CI 1.2-2.9). Sex differences in risk factors were HAV exposure for men and cold exposure for women increased the risk of cold sensitivity. Rheumatic diseases and migraine increased the risk of cold sensitivity among women but not among men.

Conclusions The present study shows that cold sensitivity is associated with both inherent factors, acquired conditions and external exposures. Among acquired conditions, frostbite, vascular disease, nerve injury, joint disorders and migraine are significantly related to the reporting of cold sensitivity. Among external exposures, both cold climate and HAV exposure are significantly associated to cold sensitivity, and thus suitable targets for primary preventive measures. There was a difference in risk factors related to sex. HAV exposure for men and cold exposure for women increased the risk of cold sensitivity.

Place, publisher, year, edition, pages
Springer-Verlag New York, 2018
Keywords
Cold exposure, Cold sensitivity, Frostbite, Hand, Raynaud’s phenomenon, Sweden
National Category
Occupational Health and Environmental Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-141016 (URN)10.1007/s00420-018-1327-2 (DOI)000443357600002 ()29808434 (PubMedID)2-s2.0-85047665099 (Scopus ID)
Projects
CHINS
Note

Originally included in thesis in manuscript form with title [Cold sensitivity and associated factors: a case-control study performed in northern Sweden]

Available from: 2017-10-20 Created: 2017-10-20 Last updated: 2018-12-04Bibliographically approved
Pettersson, H., Rissanen, S., Wahlström, J. & Rintamäki, H. (2018). Skin temperature responses to hand-arm vibration in cold and thermoneutral ambient temperatures. Industrial Health, 56(6), 545-552
Open this publication in new window or tab >>Skin temperature responses to hand-arm vibration in cold and thermoneutral ambient temperatures
2018 (English)In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 56, no 6, p. 545-552Article in journal (Refereed) Published
Abstract [en]

Hand-arm vibration (HAV) from hand-held vibrating machines increases the risk of injury in the form of vasoconstriction in the fingers, commonly named as vibration induced white fingers (VWF). Cold temperature may increase that risk. This experimental study examined and compared the effects of the skin temperature of the hands during and after exposure to HAV in thermoneutral and cold conditions. Fourteen subjects were exposed to three conditions: 25°C with HAV, 5°C with HAV or 5°C without HAV. Their skin temperatures were continuously recorded for the thumbs, index fingers, palms, and back of hands. After 20 min of acclimatization, the subjects held, for five min, two handles where the right handle could vibrate at 5 m/s2 and the left was stationary. Finally, they released their grip and stood still for 10 more min. HAV had no additional cooling effect in cold during gripping of the handles. After the subjects released the handles there was only a HAV-induced cooling effect in the left palm with on average 0.5°C colder skin temperature. A single exposure to HAV will not cause an injury such as VWF, but as the present study show: short-term exposure to HAV causes some changes in skin temperature.

Place, publisher, year, edition, pages
National Institute of Occupational Safety and Health, 2018
Keywords
Cold, Exposure, Hand-arm vibrations, Skin temperature
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-150247 (URN)10.2486/indhealth.2018-0013 (DOI)000457437000010 ()29973466 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-1789
Available from: 2018-07-25 Created: 2018-07-25 Last updated: 2019-02-20Bibliographically approved
Jonsson, D., Burström, L., Nilsson, T., Wahlström, J. & Pettersson, H. (2017). Association between Pain in Adolescence and Low Back Pain in Adulthood: Studying a Cohort of Mine Workers. Pain Research and Treatment, 2017, Article ID 3569231.
Open this publication in new window or tab >>Association between Pain in Adolescence and Low Back Pain in Adulthood: Studying a Cohort of Mine Workers
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2017 (English)In: Pain Research and Treatment, ISSN 2090-1542, E-ISSN 2090-1550, Vol. 2017, article id 3569231Article in journal (Refereed) Published
Abstract [en]

Purpose: To study the association of self-reported pain in adolescence with low back pain (LBP) in adulthood among mine workers and, also, study associations between the presence of LBP over 12-month or one-month LBP intensity during a health examination and daily ratings of LBP three and nine months later. Methods: Mixed design with data collected retrospectively, cross-sectionally, and prospectively. Data was collected using a questionnaire during a health examination and by using self-reported daily ratings of LBP three and nine months after the examination. Results: Pain prevalence during teenage years was 55% and it was 59% at age 20. Pain during teenage years had a relative risk of 1.33 (95% confidence interval 1.03-1.73) of LBP 12 months prior to the health examination, but with no associations with LBP intensity or LBP assessed by text messaging. Pain at age 20 years was not associated with any measure of LBP in adulthood. Daily ratings of LBP were associated with LBP during the health examination three and nine months earlier. Conclusions: There were no clear associations between self-reported pain in adolescence and LBP in adulthood. Self-reported daily ratings of LBP were associated with LBP from the health examination. Possible limitations for this study were the retrospective design and few participants.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2017
National Category
Occupational Health and Environmental Health Neurology
Identifiers
urn:nbn:se:umu:diva-133324 (URN)10.1155/2017/3569231 (DOI)000397914300001 ()28367328 (PubMedID)
Available from: 2017-04-05 Created: 2017-04-05 Last updated: 2018-06-09Bibliographically approved
Pettersson, H. & Sjödin, F. (2017). Buller. In: Karl Forsell och Bertil Forsberg (Ed.), Miljöälsorapport norr 2017: hälsa och miljö i norra Sverige (pp. 26-29). Umeå: Norrlands universitetssjukhus
Open this publication in new window or tab >>Buller
2017 (Swedish)In: Miljöälsorapport norr 2017: hälsa och miljö i norra Sverige / [ed] Karl Forsell och Bertil Forsberg, Umeå: Norrlands universitetssjukhus , 2017, p. 26-29Chapter in book (Other academic)
Place, publisher, year, edition, pages
Umeå: Norrlands universitetssjukhus, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-144625 (URN)978-91-7601-823-1 (ISBN)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2018-11-13Bibliographically approved
Burström, L., Aminoff, A., Björ, B., Manttari, S., Nilsson, T., Pettersson, H., . . . Wahlström, J. (2017). Musculoskeletal symptoms and exposure to whole-body vibration among open-pit mine workers in the arctic. International Journal of Occupational Medicine and Environmental Health, 30(4), 553-564
Open this publication in new window or tab >>Musculoskeletal symptoms and exposure to whole-body vibration among open-pit mine workers in the arctic
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2017 (English)In: International Journal of Occupational Medicine and Environmental Health, ISSN 1232-1087, E-ISSN 1896-494X, Vol. 30, no 4, p. 553-564Article in journal (Refereed) Published
Abstract [en]

Objectives: This cross-sectional questionnaire study was carried out at 4 open-pit mines in Finland, Norway, Russia and Sweden as part of the MineHealth project. The aim has been to compare the prevalence of musculoskeletal symptoms between drivers of mining vehicles and non-drivers. Material and Methods: The mine workers were asked whether they had suffered from any musculoskeletal symptoms during the previous 12 months in specified body regions, and to grade the severity of these symptoms during the past month. They were also asked about their daily driving of mining vehicles. Results: The questionnaire was completed by 1323 workers (757 vehicle drivers) and the reported prevalence and severity of symptoms were highest for the lower back, followed by pain in the neck, shoulder and upper back. Drivers in the Nordic mines reported fewer symptoms than non-drivers, while for Russian mine workers the results were the opposite of that. The daily driving of mining vehicles had no significant association with the risk of symptoms. Female drivers indicated a higher prevalence of symptoms as compared to male drivers. Conclusions: The study provided only weak support for the hypothesis that drivers of vehicles reported a higher prevalence of musculoskeletal symptoms than non-vehicle drivers. There were marked differences in the prevalence of symptoms among workers in various enterprises, even though the nature of the job tasks was similar.

Keywords
Questionnaire, Mining, Vibration, MSD, Whole-body, Barents
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-137900 (URN)10.13075/ijomeh.1896.00975 (DOI)000404445900003 ()28584322 (PubMedID)
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-06-09Bibliographically approved
Burström, L., Björ, B., Nilsson, T., Pettersson, H., Rödin, I. & Wahlström, J. (2017). Thermal perception thresholds among workers in a cold climate. International Archives of Occupational and Environmental Health, 90(7), 645-652
Open this publication in new window or tab >>Thermal perception thresholds among workers in a cold climate
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2017 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 7, p. 645-652Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate whether exposure to cold could influence the thermal perception thresholds in a working population.

METHODS: This cross-sectional study was comprised of 251 males and females and was carried out at two mines in the northern part of Norway and Sweden. The testing included a baseline questionnaire, a clinical examination and measurements of thermal perception thresholds, on both hands, the index (Digit 2) and little (Digit 5) fingers, for heat and cold.

RESULTS: The thermal perception thresholds were affected by age, gender and test site. The thresholds were impaired by experiences of frostbite in the fingers and the use of medication that potentially could affect neurosensory functions. No differences were found between the calculated normative values for these workers and those in other comparative investigations conducted in warmer climates.

CONCLUSIONS: The study provided no support for the hypothesis that living and working in cold climate will lead to impaired thermal perception thresholds. Exposure to cold that had caused localized damage in the form of frostbite was shown to lead to impaired thermal perception.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Cold temperature, Mine work, Neurosensory function, Normative values, Sensory threshold
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-135013 (URN)10.1007/s00420-017-1227-x (DOI)000409295700009 ()28497276 (PubMedID)
Available from: 2017-05-16 Created: 2017-05-16 Last updated: 2018-06-09Bibliographically approved
Burström, L., Hyvärinen, V., Johnsen, M. & Pettersson, H. (2016). Exposure to whole-body vibration in open-cast mines in the Barents region. International Journal of Circumpolar Health, 75, Article ID 29373.
Open this publication in new window or tab >>Exposure to whole-body vibration in open-cast mines in the Barents region
2016 (English)In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 75, article id 29373Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We aimed to measure and evaluate whole-body vibration (WBV) exposure among drivers of mining vehicles in the Barents region.

STUDY DESIGN: In the period from November 2012 to August 2014, this cross-sectional study was carried out at 3 mines in Finland, Norway and Sweden as part of the MineHealth project.

METHODS: Measurements of WBV were conducted on the surface of the driver's seat during normal work in accordance with international standards. Personal data on daily exposure times were collected by a questionnaire.

RESULTS: Measurements were conducted on 95 different mining vehicles both as root mean square (RMS) value and vibration dose value (VDV) representing different manufacturers, models and capacities. Of the 453 miners who answered the questionnaire, 232 indicated that they were exposed to WBV during their working day. The results show that the mean daily exposure time varies between 1.9 and 6.7 h for different vehicles. The calculated mean A(8) could be found in an interval between 0.2 and 1.0 m/s(2) and the corresponding 8-h VDV fell between 7 and 17 m/s(1.75).

CONCLUSIONS: Exposure to WBV among operators of mining vehicles may be a serious health and safety problem in the mines studied. The employers ought, therefore, take active steps to reduce exposure in accordance with the European vibration directive. Moreover, since some groups of drivers are exposed to vibration that is close to or exceeds the exposure limit values, the employer should take immediate action to reduce exposure below these values.

Keywords
whole-body vibration, mining, drivers, ISO2631-1, measurements
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-117235 (URN)10.3402/ijch.v75.29373 (DOI)000375136400001 ()26864832 (PubMedID)
Available from: 2016-02-24 Created: 2016-02-24 Last updated: 2018-06-07Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-7077-2389

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