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The green transition relies on metals, requiring increased metal recovery from waste. However, exposure risks among metal recycling workers are poorly understood. We conducted a cross-sectional study to assess dust and metal exposure among 139 recycling workers from 13 Swedish metal recycling companies and 90 controls. We documented work practices through observations and questionnaires and assessed dust and metal exposures using a combination of individual air sampling (inhalable (ID) and respirable dust) and biomonitoring (blood and pre-/post-shift urine). ICP-MS was used to measure 39 metals in air, 47 in blood, and 42 in urine. Thirty-two % of the workers were involved in the recycling of e-waste. At most workplaces, dust control was insufficient, respiratory protective equipment was rarely or incorrectly used, and hygienic routines were inadequate. This was reflected in 6.2 times higher ID levels in recycling workers; 14 % exceeded the 5 mg/m3 exposure limit for ID, and some also exceeded limits for Pb, Cu, As, Cd, and Sb. Workers had elevated blood and/or urine levels of Pb, Hg, Al, Sb, Fe and Mn with known human toxicity, and of Y, Lu, In, Ga, W, and Te with limited or unknown toxicity. Furthermore, observed were also co-exposure patterns for those metals. Inhalation was the likely primary exposure route for Pb, Sb, Y, In, and Te. In conclusion, Swedish recycling workers were exposed to elevated levels of dust and metals, highlighting the need for ongoing monitoring of both known and emerging metals.

Objectives: This study aimed to investigate whether introducing a digital risk assessment tool, the Swedish National Vibration Database, would increase the number of risk assessments on hand–arm and whole-body vibration. Employer and safety representatives from companies where vibration exposure is common were invited.

Methods: Of the 2953 invited companies, 1916 were selected for educational intervention and the remaining 1037 companies served as a control group with no intervention. For the educational intervention, participating companies were further divided into two groups (group A, n = 26; group B, n = 47) that both received information regarding risk assessment, but group B was also informed about the digital tool. Both groups answered a questionnaire on risk assessment before the intervention and at the follow-up, 6 months later; the control group received the same questionnaire but no education (group C, n = 22).

Results: Of the invited companies, only 2% chose to participate and 7% at follow-up. Seventy-eight percent of the participants had made some kind of risk assessment of vibration at follow-up.

Conclusion: Due to the low participation rate among invited companies, this study is not able to draw any conclusions on whether the digital tool can be used to increase the number of risk assessments.

Objectives: To characterise cold sensitivity using a semi-structured interview, physical examination, thermal quantitative sensory testing (QST), and laser speckle contrast analysis (LASCA).

Methods: Eight women and four men, ages 22–74, with cold sensitivity were interviewed andexamined by an occupational physician. Thermal perception thresholds were established using QST, on the pulp of the index and little finger of the most affected hand. Skin perfusion in the dorsum of the hand was measured using LASCA, at baseline, after two-minute 12°C water immersion, and during rewarming.

Results: The physical examination yielded few findings indicative of vascular or neurosensory pathology. One subject (8%) had impaired thermal perception thresholds. LASCA at baseline showed absent proximal-distal perfusion gradients in six subjects (50%), and a dyshomogeneousperfusion pattern in five (42%). Perfusion on a group level was virtually unchanged by cold stress testing (median 52.5 PU; IQR 9.0 before versus 51.3 PU; IQR 27.2 afterwards).

Conclusions: Physical examination and thermal QST offered little aid in diagnosing cold sensitivity, which challenges the neurosensory pathophysiological hypothesis. LASCA indicated disturbances in microvascular regulation and could prove a useful tool in future studies on cold sensitivity.

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.

PURPOSE: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms.

METHODS: A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden.

RESULTS: A total of 12,627 out of 35,144 subjects returned the questionnaire (response rate 35.9%). Subjects living in the rural alpine areas reported more extensive cold exposure both during work and leisure time compared to the urbanized coastal regions. Frostbite in the hands was present in 11.4% of men and 7.1% of women, cold sensitivity was present in 9.7 and 14.4%, and Raynaud's phenomenon was present in 11.0% of men and 14.0% of women. There was a positive association between cumulative cold exposure and neurovascular hand symptoms.

CONCLUSION: The present study demonstrates that the cold environment in northern Sweden might be an underestimated health risk. Our hypothesis that cold exposure is positively related to reporting of neurovascular hand symptoms was supported by our findings. In addition, such symptoms were common not only in conjunction with an overt cold injury. Our results warrant further study on pathophysiological mechanisms and suggest the need for confirmatory prevalence studies to support national public health planning.

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.

Coarse particle matter, PMcoarse, is associated with increased respiratory morbidity and mortality. The aim of this study was to investigate the association between short-term changes in PMcoarse and sub-clininal airway inflammation in children. Healthy children aged 11 years from two northern Swedish elementary schools underwent fraction of exhaled nitrogen oxide (FENO) measurements to determine levels of airway inflammation twice weekly during the study period from 11 April-6 June 2011. Daily exposure to PMcoarse, PM2.5, NO2, NOx, NO and O-3 and birch pollen was estimated. Multiple linear regression was used. Personal covariates were included as fixed effects and subjects were included as a random effect. In total, 95 children participated in the study, and in all 493 FENO measurements were made. The mean level of PMcoarse was 16.1 mu g/m(3) (range 4.1-42.3), and that of O-3 was 75.0 mu g/m(3) (range: 51.3-106.3). That of NO2 was 17.0 mu g/m(3) (range: 4.7-31.3), NOx was 82.1 mu g/m(3) (range: 13.3-165.3), and NO was 65 mu g/m(3) (range: 8.7-138.4) during the study period. In multi-pollutant models an interquartile range increase in 24 h PMcoarse was associated with increases in FENO by between 6.9 ppb (95% confidence interval 0.0-14) and 7.3 ppb (95% confidence interval 0.4-14.9). PMcoarse was associated with an increase in FENO, indicating sub-clinical airway inflammation in healthy children.

OBJECTIVES: To evaluate a method for collecting data concerning low back pain (LBP) using daily text messages and to characterize the reported LBP in terms of intensity, variability, and episodes.

STUDY DESIGN AND SETTING: We conducted a cohort study of LBP among workers used by a mining company. The participants were asked to answer the question "How much pain have you had in your lower back in the last 24 hours on a scale from 0 to 10, where 0 = no pain and 10 = the worst pain imaginable" once a day for 5 weeks, with this process being repeated 6 months later.

RESULTS: A total of 121 workers participated in the first period of data collection, and 108 participated in the second period. The daily response rate was 93% for both periods, and cluster analysis was shown to be a feasible statistical method for clustering LBP into subgroups of low, medium, and high pain. The daily text messages method also worked well for assessing the episodic nature of LBP.

CONCLUSION: We have demonstrated a method for repeatedly measuring of LBP using daily text messages. The data permitted clustering into subgroups and could be used to define episodes of LBP.