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  • 1.
    Burström, Lage
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Aminoff, Anna
    Björ, Bodil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Manttari, Sate
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Rintamaki, Hannu
    Rodin, Ingemar
    Shilov, Victor
    Talykomv, Ljudmila
    Vaktskjold, Arild
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Musculoskeletal symptoms and exposure to whole-body vibration among open-pit mine workers in the arctic2017Ingår i: International Journal of Occupational Medicine and Environmental Health, ISSN 1232-1087, E-ISSN 1896-494X, Vol. 30, nr 4, s. 553-564Artikel i tidskrift (Refereegranskat)
    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.

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  • 2.
    Burström, Lage
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Björ, Bodil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Rödin, Ingemar
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Thermal perception thresholds among workers in a cold climate2017Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, nr 7, s. 645-652Artikel i tidskrift (Refereegranskat)
    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.

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  • 3.
    Burström, Lage
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, SE-405 30 Gothenburg, Sweden.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lundström, Ronnie
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
    Nilsson, Tohr
    Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, SE-851 86 Sweden.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, SE-405 30 Gothenburg, Sweden.
    A follow-up study of welders’ exposure to vibration in a heavy engineering production workshop2010Ingår i: Journal of Low Frequency Noise Vibration and Active Control, ISSN 0263-0923, Vol. 29, nr 1, s. 33-39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Manual work involving vibrating power tools is associated with symptoms that include vascular, neurological and musculoskeletal disorders. This study examines the vibration exposure of welders to determine the change between 1987 and 2008. Vibration measurements on handheld tools were used to evaluate the acceleration and the daily exposure time was determined by subjective rating. From these data, the 8-hour equivalent vibration exposure A(8), has been calculated. During the period, the A(8) decreased from 3.9 m/s2 to 1.9 m/s2. It was concluded that this decrease is the result of fewer vibrating tools and a decrease in daily exposure time. Although the daily vibration exposure has decreased over the study time, for some welders the daily vibration exposure A(8) is still above the action value set by the EU directive on vibration. This means more effort should be spent to decrease vibration exposure.

  • 4.
    Burström, Lage
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Hyvärinen, Ville
    Johnsen, Magnar
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Arktiskt centrum vid Umeå universitet (Arcum).
    Exposure to whole-body vibration in open-cast mines in the Barents region2016Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, artikel-id 29373Artikel i tidskrift (Refereegranskat)
    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.

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  • 5.
    Carlsson, Daniel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Neurosensory and vascular function after 14 months of military training comprising cold winter conditions2016Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, nr 1, s. 61-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.
    Carlsson, Daniel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    Avd för samhällsmedicin och folkhälsa vid Institutionen för medicin, Göteborgs universitet.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Diagnostisk radiologi. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Can sensation of cold hands predict Raynaud’s phenomenon or paresthesia?2018Ingår i: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 68, nr 5, s. 314-319Artikel i tidskrift (Refereegranskat)
    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.

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  • 7. Jonsson, David
    et al.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Association between Pain in Adolescence and Low Back Pain in Adulthood: Studying a Cohort of Mine Workers2017Ingår i: Pain Research and Treatment, ISSN 2090-1542, E-ISSN 2090-1550, Vol. 2017, artikel-id 3569231Artikel i tidskrift (Refereegranskat)
    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.

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  • 8.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Modig, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Arbetsolyckor vid användning av rullställningar i byggbranschen2022Rapport (Övrigt vetenskapligt)
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  • 9.
    Lewkowski, Kate
    et al.
    School of Public Health, Curtin University, Bentley, WA, Perth, Australia.
    Ytterstad, Elinor
    Department of Mathematics and Statistics, UiT - the Arctic University of Norway, Tromsø, Norway.
    Pugliese, Matthew J
    UWA Medical School, The University of Western Australia, WA, Crawley, Australia.
    McCausland, Kahlia
    School of Public Health, Curtin University, Bentley, WA, Perth, Australia.
    Heyworth, Jane S
    School of Population and Global Health, The University of Western Australia, WA, Crawley, Australia.
    Li, Ian W
    School of Population and Global Health, The University of Western Australia, WA, Crawley, Australia.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Williams, Warwick
    National Acoustics Laboratory, NSW, Macquarie Park, Australia.
    Fritschi, Lin
    School of Public Health, Curtin University, Bentley, WA, Perth, Australia.
    Exposure to Hand-Arm Vibration in the Australian Workforce2021Ingår i: Annals of Work Exposures and Health, ISSN 2398-7308 , E-ISSN 2398-7316 , Vol. 65, nr 6, s. 659-667Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To estimate the prevalence of hand-arm vibration (HAV) in Australian workplaces.

    Methods: The Australian Workplace Exposure Survey (AWES)—Hearing was a cross-sectional telephone survey of Australian workers conducted in 2016–2017. Respondents were asked about the time spent using tools or performing tasks known to be associated with HAV during their most recent working day. We created a library of HAV magnitude levels for each tool/task and estimated each worker’s daily HAV exposure level using standard formulae. We categorized each worker as to whether they exceeded the daily occupational limits of 2.5 and 5.0 m/s2. Results were extrapolated to the Australian working population using a raked weighting method.

    Results: In our sample of 4991 workers, 5.4% of men and 0.7% of women exceeded the HAV action limit of 2.5 m/s2 on their most recent working day. We estimate that 3.8% of the Australian workforce exceeds the HAV limit of 2.5 m/s2 and 0.8% exceeds the 5 m/s2 limit. Men were more likely to exceed the HAV limits than women, as were those with trade qualifications, and those who worked in remote locations. Workers in the construction, farming, and automobile industries had the highest prevalence of HAV exposure. Tool groups that contributed to higher exposure levels included: compactors, rollers, and tampers; power hammers and jackhammers; and underground mining equipment.

    Conclusions: HAV is common in the Australian working population. Given the health risks associated with this exposure, reduction strategies and interventions should be developed, with engineering controls as the starting point for exposure reduction strategies.

  • 10.
    Liljelind, Ingrid
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Toomingas, Allan
    Karolinska Institutet, Institute of Environmental Medicine, Unit of Occupational Medicine SE-171 76 Stockholm, Sweden.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Determinants Explaining the Variability of Hand-Transmitted Vibration Emissions From Two Different Work Tasks: Grinding and Cutting Using Angle Grinders2013Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 57, nr 8, s. 1065-1077Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are numerous factors including physical, biomechanical, and individual that influence exposure to hand-transmitted vibration (HTV) and cause variability in the exposure measurements. Knowledge of exposure variability and determinants of exposure could be used to improve working conditions. We performed a quasi-experimental study, where operators performed routine work tasks in order to obtain estimates of the variance components and to evaluate the effect of determinants, such as machine–wheel combinations and individual operator characteristics.

    Methods: Two pre-defined simulated work tasks were performed by 11 operators: removal of a weld puddle of mild steel and cutting of a square steel pipe. In both tasks, four angle grinders were used, two running on compressed air and two electrically driven. Two brands of both grinding and cutting wheels were used. Each operator performed both tasks twice in a random order with each grinder and wheel and the time to complete each task was recorded. Vibration emission values were collected and the wheel wear was measured as loss of weight. Operators’ characteristics collected were as follows: age, body height and weight, length and volume of their hands, maximum hand grip force, and length of work experience with grinding machines (years). The tasks were also performed by one operator who used four machines of the same brand. Mixed and random effects models were used in the statistical evaluation.

    Results: The statistical evaluation was performed for grinding and cutting separately and we used a measure referring to the sum of the 1-s r.m.s. average frequency-weighted acceleration over time for completing the work task (a sa). Within each work task, there was a significant effect as a result of the determinants ‘the machine used’, ‘wheel wear’, and ‘time taken to complete the task’. For cutting, ‘the brand of wheel’ used also had a significant effect. More than 90% of the inherent variability in the data was explained by the determinants. The two electrically powered machines had a mean a sa that was 2.6 times higher than the two air-driven machines. For cutting, the effect of the brand of wheel on a sa was ~0.1 times. The a sa increased both with increasing wheel wear and with time taken to complete the work task. However, there were also a number of interaction effects which, to a minor extent, modified the a sa. Only a minor part (1%) of the total variability was attributed to the operator: for cutting, the volume of the hands, maximum grip force, and body weight were significant, while for grinding, it was the maximum grip force. There was no clear difference in a sa between the four copies of the same brand of each machine.

    Conclusions: By including determinants that were attributed to the brand of both machine and wheel used as well as the time taken to complete the work task, we were able to explain >90% of the variability. The dominating determinant was the brand of the machine. Little variability was found between operators, indicating that the overall effect as due to the operator was small.

  • 11.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Risk of hearing loss from combined exposure to hand-arm vibrations and noise2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Många arbetare använder sig av handhållna vibrerande verktyg. Det utsätter dem för höga nivåer av både buller och vibrationer. Människor som utsätts för höga bullernivåer under lång tid kan skada sin hörsel. Risken för hörselnedsättning orsakad av buller kan eventuellt öka om personen samtidigt är utsatt för vibrationer från handhållna vibrerande verktyg. Syftet med avhandlingen var att studera om vibrationer i kombination med buller ökar risken för hörselnedsättning.

    Avhandlingen består av fyra studier. Den första studien är en experimentell studie med 22 friska deltagare med god hörsel. Denna studie undersökte hur hörseln tillfälligt påverkas av buller och vibrationer, separat och i kombination. Den andra och tredje studien bygger på en population bestående av 189 verkstadsarbetare i Sundsvall som följts regelbundet sedan 1987. Den andra studien undersökte om det finns en ökad risk för hörselnedsättning för arbetare som utsätts för buller och vibrationer under lång tid. Den tredje studien undersökte om arbetare med vita fingrar har en ökad risk för hörselnedsättning än arbetare utan vita fingrar.

    Vita fingrar är en kärlskada orsakad av vibrationer som gör att fingrarna reagerar onormalt snabbt på kyla. Fingrarna blir vita när blodtillförseln till dem stryps. Den fjärde studien är en enkätstudie med 342 kvinnor och män som har en bekräftad hörselnedsättning orsakad av buller. Studien undersökte hur många ur denna grupp som utsätts för vibrationer samt har vita fingrar.

    Resultaten från studierna visar att det inte finns någon skillnad i hörselpåverkan från buller och vibrationer i kombination jämfört med enbart buller under kort tid. De som utsätts för vibrationer från handhållna vibrerande verktyg i en bullrig miljö under lång tid har en ökad risk för hörselnedsättning. Arbetare med vita fingrar har en högre risk för hörselnedsättning än de utan. En hög andel av de med hörselnedsättning orsakad av buller använder sig av handhållna vibrerande verktyg. I studien fanns även en hög andel med vita fingrar.

    Sammanfattningsvis visar resultaten att det finns en långtidseffekt av buller och vibrationer på hörselnedsättning men inte någon korttidseffekt, och att vita fingrar kan påverka risken för hörselnedsättning.

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  • 12.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, Sweden.
    Noise and hand-arm vibration exposure in relation to the risk of hearing loss2012Ingår i: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 14, nr 59, s. 159-165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to examine the possible association of combined exposure of noise and hand-arm vibration (HAV) and the risk of noise-induced hearing loss. Workers in a heavy engineering industry were part of a dynamic cohort. Of these workers, 189 had HAV exposure, and their age and hearing status were recorded in the same year and were, therefore, included in the analysis. Data on HAV duration and acceleration was gathered through questionnaires, observations, and measurements. All available audiograms were categorized into normal and hearing loss. The first exposure variable included the lifetime HAV exposure. The lifetime HAV exposure was multiplied by the acceleration of HAV for the second and third exposure variable. Logistic regression using the Generalized Estimation Equations method was chosen to analyze the data to account for the repeated measurements. The analysis was performed with both continuous exposure variables and with exposure variables grouped into exposure quartiles with hearing loss as an outcome and age as a covariate. With continuous exposure variables, the odds ratio (OR) with a 95% confidence interval (CI) for hearing loss was equal to or greater than one for all exposure variables. When the exposure variables were grouped into quartiles, the OR with a 95% CI was greater than one at the third and fourth quartile. The results show that working with vibrating machines in an environment with noise exposure increases the risk of hearing loss, supporting an association between exposure to noise and HAV, and the noise-induced hearing loss.

  • 13.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Risk of Hearing Loss Among Workers with Vibration-Induced White Fingers2014Ingår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 57, nr 12, s. 1311-1318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: We examined the risk of hearing loss for workers who use hand-held vibrating tools with vibration-induced white fingers (VWF) compared to workers without VWF. Methods: Data on 184 participants from a 21-year cohort were gathered with questionnaires and measurements. The effects on hearing status of VWF, hand-arm vibration exposure, smoking habits, age and two-way interactions of these independent variables were examined with binary logistic regression. Analyses were made for the right hand and ear as well as for the hand with VWF and the ear with worse categorized hearing status. Results: Workers with VWF in their right hand had an increased risk of hearing loss (odds ratio 2.2-2.3) in the right ear. Workers with VWF in any hand did not have any increased risk of hearing loss in the ear with worse hearing status. Conclusions: This study supports the hypothesis that VWF increases the risk of hearing loss among workers who use hand-held vibrating tools in a noisy environment. Am. J. Ind. Med. 57:1311-1318, 2014. (c) 2014 Wiley Periodicals, Inc.

  • 14.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    University of Gothenburg, Department of Public Health and Community Medicine, Gothenburg, Sweden.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Risk of hearing loss in relation to vibration-induced white fingers among workers using hand-held vibrating toolsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background Vibration-induced white fingers (VWF) may increase the risk of hearing loss among workers using hand-held vibrating machines who are exposed to noise and hand-arm vibrations (HAV). The present study uses a 21-year follow-up cohort of workers who use hand-held vibrating machines. The aim of this study is to examine the risk of hearing loss for workers with and without VWF who use hand-held vibrating tools.

    Methods All 184 participants used hand-held vibrating machines and were part of a Swedish cohort. At each follow-up each participant answered a questionnaire on basic individual data, use of hand-held vibrating tools, and VWF symptoms. The VWF symptoms were categorized as with or without VWF. HAV acceleration was measured at each follow-up. Hearing threshold levels from audiometric measurements were categorized as normal hearing and hearing loss. Two exposure estimates were used and divided into two exposure groups: lifetime exposure to HAV (Time) and lifetime exposure to HAV multiplied by acceleration (TimeAcc). To be included in the analysis, each participant had to have hearing status, categorized VWF symptoms, exposure estimates and stated smoking habits measured in the same year for either 1987, 1992, 1997, 2002, or 2008. The relationship between binary outcome of hearing status and the interaction of the explanatory variables, i.e. categorized VWF symptoms, exposure estimates, smoking habits and age, were calculated using binary logistic regression. Because of the repeated measurement of these variables, the Generalized Estimating Equations procedure with a first-order autoregressive correlation structure was used. Three analyses were made for left hand and left ear, right hand and right ear, and hand with worst categorized VWF symptoms and ear with worst categorized hearing status.

    Results In our study, there was an interaction between exposure estimates (Time and TimeAcc) with the variable categorized VWF symptoms in the left hand on the risk of hearing loss in the left ear. Workers with VWF in the left hand had an increased risk of hearing loss in the left ear if they were in the low exposure group (OR 4.7-7.1) but not in the high exposure groups. There was an increased risk of hearing loss in the left ear for workers in the high exposure group without VWF in the left hand (OR 3.3-3.6) but not for workers with VWF. Workers with VWF in their right hand had an increased risk of hearing loss (OR 2.2-2.3) in the right ear compared to workers without VWF. Workers with VWF on the hand with worst categorization according to the Stockholm Workshop Scale (SWS) for the vascular component did not have any increased risk of hearing loss in the ear with worse hearing status.

    Conclusions We found that workers with VWF who are using hand-held vibrating machines had an increased risk of hearing loss compared to workers without VWF. This result supports an association between VWF and an increased risk of hearing loss among workers using hand-held vibrating tools in a noisy environment.

  • 15.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Raynaud's phenomenon among men and women with noise-induced hearing loss in relation to vibration exposure2014Ingår i: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 16, nr 69, s. 89-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Raynaud's phenomenon is characterized by constriction in blood supply to the fingers causing finger blanching, of white fingers (WF) and is triggered by cold. Earlier studies found that workers using vibrating hand-held tools and who had vibration-induced white fingers (VWF) had an increased risk for hearing loss compared with workers without VWF. This study examined the occurrence of Raynaud's phenomenon among men and women with noise-induced hearing loss in relation to vibration exposure. All 342 participants had a confirmed noise-induced hearing loss medico legally accepted as work-related by AFA Insurance. Each subject answered a questionnaire concerning their health status and the kinds of exposures they had at the time when their hearing loss was first discovered. The questionnaire covered types of exposures, discomforts in the hands or fingers, diseases and medications affecting the blood circulation, the use of alcohol and tobacco and for women, the use of hormones and whether they had been pregnant. The participation rate was 41% (n = 133) with 38% (n = 94) for men and 50% (n = 39) for women. 84 men and 36 women specified if they had Raynaud's phenomenon and also if they had used hand-held vibrating machines. Nearly 41% of them had used hand-held vibrating machines and 18% had used vibrating machines at least 2 h each workday. There were 23 men/6 women with Raynaud's phenomenon. 37% reported WF among those participants who were exposed to hand-arm vibration (HAV) and 15% among those not exposed to HAV. Among the participants with hearing loss with daily use of vibrating hand-held tools more than twice as many reports WF compared with participants that did not use vibrating hand-held tools. This could be interpreted as Raynaud's phenomenon could be associated with an increased risk for noise-induced hearing loss. However, the low participation rate limits the generalization of the results from this study.

  • 16.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    The effect on the temporary threshold shift in hearing acuity from combined exposure to authentic noise and hand-arm vibration2011Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, nr 8, s. 951-957Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study examined and compared the effect on temporary threshold shift in hearing (TTS) in healthy subjects of noise and hand-arm vibration (HAV) combined and separately using controlled and authentic exposure conditions. This study also investigated the effect on TTS in hearing in relation to gender after such exposures.

    Twenty-two healthy subjects (11 men/women, mean age 22 years, range 18-31 years) were exposed both separately and in combination with HAV (6.7 m/s(2)), using vibrating handles and to noise (99dB(A)) using headphones, for 20 min. The HAV and noise were reproduced from recordings from angular grinder in operation. Hearing thresholds at 1, 4, and 8 kHz were measured before and up to 30 min after exposure. 

    Combined exposure to noise and HAV created significantly greater TTS in hearing than HAV exposure at 4 and 8 kHz alone. After exposure to HAV, there was no significant change in hearing threshold. At 1 kHz, there was a significant difference between noise and HAV exposure in TTS in hearing. There was no significant difference between combined exposure and noise exposure for any test frequency. There was no significant difference in TTS in hearing in relation to gender for 1, 4, and 8 kHz for HAV, noise, or a combined exposure.

    The results indicate that there is no difference in the TTS in hearing after combined exposure compared to noise exposure alone. HAV exposure did not change the hearing threshold. The TTS in hearing did not differ significantly in relation to gender after HAV, noise, or combined exposure.

  • 17.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Graff, Pål
    Department of Work Environment Chemistry, National Institute of Occupational Health, Norway.
    Fornander, Louise
    Faculty of Medicine and Health, Örebro University, Sweden.
    Westerlund, Jessica
    Faculty of Medicine and Health, Örebro University, Sweden.
    Björ, Bodil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Sjödin, Fredrik
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Introducing a new design of digital tool to increase vibration risk assessments: challenges with education-based interventions2022Ingår i: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 28, nr 3, s. 1705-1710Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 18.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Olsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational exposure to noise and cold environment and the risk of death due to myocardial infarction and stroke2020Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, nr 5, s. 571-575Artikel i tidskrift (Refereegranskat)
    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.

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  • 19.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Finnish Institute of Occupational Health, Finland.
    Rissanen, Sirkka
    Finnish Institute of Occupational Health, Finland.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Rintamäki, Hannu
    Finnish Institute of Occupational Health, Finland; Research Unit of Biomedicine, University of Oulu, Finland..
    Skin temperature responses to hand-arm vibration in cold and thermoneutral ambient temperatures2018Ingår i: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 56, nr 6, s. 545-552Artikel i tidskrift (Refereegranskat)
    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.

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  • 20.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sjödin, Fredrik
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Buller2017Ingår i: Miljöälsorapport norr 2017: hälsa och miljö i norra Sverige / [ed] Karl Forsell och Bertil Forsberg, Umeå: Norrlands universitetssjukhus , 2017, s. 26-29Kapitel i bok, del av antologi (Övrigt vetenskapligt)
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  • 21. Skröder, H.
    et al.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Norlén, F.
    Gustavsson, P.
    Rylander, L.
    Albin, M.
    Selander, J.
    Occupational exposure to whole body vibrations and birth outcomes - A nationwide cohort study of Swedish women2021Ingår i: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 751, artikel-id 141476Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: More women in reproductive ages are entering occupations where exposure to whole body vibrations (WBV) is common (e.g. in transportation and construction). Previous studies based on self-assessed exposure suggest increased risks of adverse birth outcomes, but it is unclear at what exposure levels and if the current exposure guidelines are appropriate during pregnancy.

    Objectives: To investigate whether occupational WBV-exposure increases the risk of preterm birth, low birth weight, and/or small-for-gestational age, in a large, nationwide, prospective, cohort study.

    Design: The Fetal Air Pollution Exposure cohort (FAIR) was formed by merging data from multiple, national registers, and the present study includes singletons born 1994–2014 to working women in Sweden (n = 1,091,080 births). WBV-exposure was assessed quantitatively using a job-exposure matrix based on measurements, and calculated odds ratios were adjusted for potential confounders such as smoking and BMI, and other occupational exposures like noise, combustion particles, and physically and psychologically strenuous work. Data on absence from work (full-/part time, sick leave, parental leave, etc.) was also used.

    Results: Exposure to WBV during pregnancy, among women with low absence from work (n = 476,419), was associated with an increased risk of preterm birth, below the occupational exposure limit (1.15 m/s2). Compared to unexposed mothers, the OR was 1.38 (95% CI: 1.05, 1.83) for exposure ≥0.5 m/s2, corresponding to an increase from 47/1000 cases to 65/1000 cases. No increased risk was found for small-for-gestational age.

    Conclusions: Exposure to WBV was associated with an increased risk of preterm birth. The results suggest that the current permissible exposure and action levels for WBV-exposure do not adequately protect pregnant women with continuous exposure.

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  • 22. Skröder, Helena
    et al.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Albin, Maria
    Gustavsson, Per
    Rylander, Lars
    Norlén, Filip
    Selander, Jenny
    Occupational exposure to whole-body vibrations and pregnancy complications: a nationwide cohort study in Sweden2020Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 77, nr 10, s. 691-698Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Pregnancy complications are common contributors to perinatal mortality and morbidity. Still, the cause(s) of gestational hypertensive disorders and diabetes are largely unknown. Some occupational exposures have been inconsistently associated with pregnancy complications, but exposure to whole-body vibrations (WBV) has been largely overlooked even though it has been associated with adverse birth outcomes. Therefore, the aim was to assess whether occupational WBV exposure during pregnancy is associated with pregnancy complications in a nationwide, prospective cohort study.

    Methods: The Fetal Air Pollution Exposure cohort was formed by merging multiple Swedish, national registers containing information on occupation during pregnancy and diagnosis codes, and includes all working women who gave birth between 1994 and 2014 (n=1 091 044). WBV exposure was derived from a job-exposure matrix and was divided into categories (0, 0.1–0.2, 0.3–0.4 and ≥0.5 m/s2). ORs with 95% CIs were calculated using logistic regression adjusted for potential confounders.

    Results: Among women working full time (n=646 490), we found increased risks of all pregnancy complications in the highest exposure group (≥0.5 m/s2), compared with the lowest. The adjusted ORs were 1.76 (95% CI 1.41 to 2.20), 1.55 (95% CI 1.26 to 1.91) and 1.62 (95% CI 1.07 to 2.46) for preeclampsia, gestational hypertension and gestational diabetes, respectively, and were similar in all sensitivity analyses. There were no clear associations for part-time workers.

    Conclusions: The results suggest that women should not be exposed to WBV at/above the action limit value of 0.5 m/s2 (European directive) continuously through pregnancy. However, these results need further confirmation.

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  • 23.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Abu Mdaighem, Mahmoud
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational noise exposure and Raynaud's phenomenon: a nested case-control study2021Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 80, nr 1, artikel-id 1969745Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary aim of this study was to determine if self-reported occupational noise exposure was associated with Raynaud's phenomenon. In northern Sweden, a nested case-control study was performed on subjects reporting Raynaud's phenomenon (N=461), and controls (N=763) matched by age, sex and geographical location. The response rate to the exposure questionnaire was 79.2%. The study showed no statistically significant association between occupational noise exposure and reporting Raynaud's phenomenon (OR 1.10; 95% CI 0.83-1.46) in simple analyses. However, there was a trend towards increasing OR for Raynaud's phenomenon with increasing noise exposure, although not statistically significant. Also, there was a significant association between noise exposure and hearing loss (OR 2.76; 95% CI 2.00-3.81), and hearing loss was associated with reporting Raynaud's phenomenon (OR 1.52; 95% CI 1.03-2.23) in a multiple regression model. In conclusion, self-reported occupational noise exposure was not statistically significantly associated with Raynaud's phenomenon, but there was a dose-effect trend. In addition, the multiple model showed a robust association between hearing loss and Raynaud's phenomenon. These findings offer some support for a common pathophysiological background for Raynaud's phenomenon and hearing loss among noise-exposed workers, possibly through noise-induced vasoconstriction.

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  • 24.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Björ, Bodil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Manifestations of cold sensitivity: a case series2020Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 79, nr 1, artikel-id 1749001Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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  • 25.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden. .
    Carlsson, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden2018Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, nr 7, s. 785-797Artikel i tidskrift (Refereegranskat)
    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.

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  • 26.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Johnsen, Magnar
    Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Aminoff, Anna
    Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Höper, Anje Christina
    Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Neurosensory and vascular symptoms and clinical findings in the hands of Arctic open-pit miners in Sweden and Norway: a descriptive study2023Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, nr 1, artikel-id 2254916Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This cross-sectional study aimed to describe exposure to cold climate and hand-arm vibration (HAV) as well as neurosensory and vascular symptoms and clinical findings among open-pit Arctic miners. It was based on data from questionnaires and physical examinations, including 177 men and 75 women from two open-pit mines in Sweden and Norway (response rate 54%). Working outdoors or in an unheated building or machine for at least two hours per day was reported by 44% and HAV exposure of the same duration by 10%. Neurosensory symptoms (e.g. reduced perception of touch) in the hands were reported by 47% and Raynaud’s phenomenon by 14%. In brief conclusion, the study showed that Arctic miners were commonly exposed to both cold temperatures and HAV. They also reported a broad range of neurosensory and vascular symptoms in their hands and had abnormal clinical findings related to the symptoms. The results emphasise the need for additional preventive measures in this occupational setting.

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  • 27.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Raynaud's phenomenon in Northern Sweden: a population-based nested case-control study2019Ingår i: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 39, nr 2, s. 265-275Artikel i tidskrift (Refereegranskat)
    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.

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  • 28.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Incidence, remission, and persistence of Raynaud’s phenomenon in the general population of northern Sweden: a prospective study2022Ingår i: BMC Rheumatology, ISSN 2520-1026, Vol. 6, nr 1, artikel-id 41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Raynaud’s phenomenon is common condition, but little is known about the natural course. The primary aim of this study was to determine the incidence, remission, and persistence proportions of Raynaud’s phenomenon in the general population of northern Sweden. Secondary aims were to determine how individual and exposure factors affect the course of Raynaud’s phenomenon, and to assess gender differences.

    Methods: A prospective, survey-based, closed-cohort study was conducted on a sample of men and women between 18–70 years of age, living in northern Sweden. Data on Raynaud’s phenomenon characteristics and general health status were collected during the winters of 2015 (baseline) and 2021 (follow-up). Rates of incidence, remission, and persistence were calculated. Binary logistic regression was used to determine the association between baseline variables and the course of Raynaud’s phenomenon. Results: The study population consisted of 2703 women (53.9%) and 2314 men. There were 390 women (14.5%) and 290 men (12.7%) reporting Raynaud’s phenomenon in the follow-up survey. The annual incidence proportion was 0.7% among women and 0.9% among men (gender difference p = 0.04). The annual remission proportion was 4.4% and 5.5%, respectively (p = 0.05). Having sustained a cold injury affecting the hands since baseline was significantly associated with incident Raynaud’s phenomenon (OR 3.92; 95% CI 2.60–5.90), after adjusting for age and gender.

    Conclusions: In the general population of northern Sweden, Raynaud’s phenomenon is a common but variable condition, where symptoms may remit over time. Men had a higher incidence proportion than women. The results support a possible causal pathway where cold injury can precede the onset of Raynaud’s phenomenon.

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  • 29.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Vihlborg, Per
    Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Höper, Anje Christina
    Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Aminoff, Anna
    Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Raynaud’s phenomenon in the feet of Arctic open-pit miners2024Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 83, nr 1, artikel-id 2295576Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The literature on Raynaud’s phenomenon (RP) in the feet is scarce, especially in the occupational setting. The primary aim of our study was to investigate the occurrence of RP in the feet of miners. As part of the MineHealth project, written surveys and clinical examinations were completed by 260 Arctic open-pit miners working in northern Sweden and Norway (participation rate 53.6%). Data on RP were collected using standardised colour charts and questionnaire items. Clinical examination included assessing the perception of vibration and pain in both feet. There were eight women and three men who reported RP in the feet. Four also had RP in their hands but none acknowledged any first-degree relatives with the condition. Nine reported exposure to foot-transmitted vibration and one to hand-arm vibration. Seven showed signs of neurosensory injury in the feet. To conclude, the occurrence of RP in the feet of miners was 4.4%. Most cases with RP in the feet did not report the condition in the hands and were exposed to vibration transmitted directly to the feet. There were no reports of a hereditary component. Most cases with RP in the feet also had clinical findings suggestive of peripheral neuropathy in the feet.

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  • 30.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Vihlborg, Per
    Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lewis, Charlotte A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational exposure to whole-body vibration and neck pain in the Swedish general population2024Ingår i: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 67, nr 2, s. 136-147Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary aim of this study was to determine if occupational exposure to whole-body vibration (WBV) was associated with reporting neck pain. A cross-sectional study was conducted on a sample of the general population living in northern Sweden, aged 24-76 years. Data was retrieved through a digital survey that collected subjectively reported information on exposure to WBV and biomechanical exposures as well as neck pain. The study included 5,017 participants (response rate 44%). Neck pain was reported by 269 men (11.8%) and 536 women (20.2%). There was a statistically significant association between reporting occupational exposure to WBV half the time or more (adjusted OR 1.91; 95% CI 1.22-3.00) and reporting neck pain. In gender-stratified analyses, the same pattern was observed in men, while there were too few women to determine any association. We conclude that occupational exposure to whole-body vibration was associated with neck pain in men.

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  • 31.
    Stjernbrandt, Albin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Wahlström, Viktoria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Lewis, Charlotte A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational cold exposure is associated with upper extremity pain2023Ingår i: Frontiers in Pain Research, ISSN 2673-561X, Vol. 4, artikel-id 1063599Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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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  • 32.
    Vihlborg, Per
    et al.
    Department of Geriatrics and Odensbackens Health Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Pettersson, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Makdoumi, Karim
    Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Wikström, Sverre
    School of Medical Sciences, Örebro University, Örebro, Sweden; Center for Clinical Research and Education, County Council of Värmland, Sweden.
    Bryngelsson, Ing-Liss
    Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Selander, Jenny
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Graff, Pål
    National Institute of Occupational Health (STAMI), Oslo, Norway.
    Carpal Tunnel Syndrome and Hand-Arm Vibration: A Swedish National Registry Case-Control Study2022Ingår i: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 64, nr 3, s. 197-201Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the increased risk for carpal tunnel syndrome (CTS) in men and women with hand-arm vibration (HAV) exposure. DESIGN: Case-control study of CTS where 4396 cases was obtained from National Outpatient Register between 2005 through 2016. Cases were matched to controls and exposure was estimated using a job exposure matrix. RESULTS: Exposure to HAV increased the risk of CTS with an OR of 1.61 (95% CI 1.46-1.77). The risk was highest in men <30 years of age and among women <30 years no increased risk was observed. The risk increased with a mean year exposure above 2.5 m/s2 to OR 1.84 (95% CI 1.38-2.46). CONCLUSIONS: HAV exposure increase the risk of CTS in both genders, with highest risk increase in younger men. This emphasize identification of HAV exposure in patients with CTS.

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