The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide FINRISK 2002 health survey performed in Finland, 8,723 people aged 25-64 years filled in a questionnaire asking about the number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases, and degradation of performance. Cold thermal sensations at +5 degrees C to -5 degrees C were reported by 35% of men and 46% of women. Almost all subjects reported at least some cold-related complaints, most commonly musculoskeletal pain (men 30%, women 27%), followed by respiratory (25% / 29%), white finger (15% / 18%) and episodic peripheral circulation symptoms (12% / 15%). Decreased mental or physical performance in cold was reported by 75% of men and 70% of women, most commonly impairing manual dexterity and tactile sense. With declining temperature, the first symptom to emerge was pain in the elbow or the forearm (at -3 degrees C), followed by increased excretion of mucus from the lungs (-5 degrees C), while most other symptoms appeared only at lower temperatures of -15 degrees C to -20 degrees C. Most symptoms showed little or no association with the weekly duration of exposure, with the exception of cold-induced pain at most sites. Although, in general, Finns are well adapted to the cold climate, the high prevalence of cold-related complaints poses a challenge to the health care system in terms of decreased performance and the possibility that such symptoms predict more serious health effects, such as increased mortality.

Recently, Geographical Information System (GIS) has emerged as an innovative and important component of many projects in public health and epidemiology. One of the most useful functions of GIS in epidemiology continues to be its utility in basic mapping. GIS may also involve more sophisticated spatial analysis of disease occurrence and contributing environmental factors. Depending on the quantity and quality of data and the methodology used in analysis, a given map may be either useful or misleading. Although visual analyses (mapped evidence) strengthened by exploratory analyses are mostly sufficient for epidemiologists, the formal testing of certain hypotheses or the estimation of relationships between measures of disease incidence and, for example, environmental covariates require quantitative modelling of disease distribution. It is a promising prospect that spatial statistics and GIS technology have slowly started to merge. However, whether GIS will be useful in the model-based approach and the prediction in, for example, epidemiology remains to be seen. The desired future development of GIS requires a switch of emphasis from data and information to knowledge.

The extent of outdoor exposure during winter and factors affecting it were examined in a cross-sectional population study in Finland. Men and women aged 25-74 years from the National FINRISK 2002 sub-study (n=6,591) were queried about their average weekly occupational, leisure-time and total cold exposure during the past winter. The effects of gender, age, area of residence, occupation, ambient temperature, self-rated health, physical activity and education on cold exposure were analysed. The self-reported median total cold exposure time was 7 h/week (8 h men, 6 h women),<1 h/week (2 h men, 0 h women) at work, 4 h/week (5 h men, 4 h women) during leisure time and 1 h/week (1 h men, 1.5 h women) while commuting to work. Factors associated with increased occupational cold exposure among men were: being employed in agriculture, forestry and industry/mining/construction or related occupations, being less educated and being aged 55-64 years. Factors associated with increased leisure-time cold exposure among men were: employment in industry/mining/construction or related occupations, being a pensioner or unemployed, reporting at least average health, being physically active and having college or vocational education. Among women, being a housewife, pensioner or unemployed and engaged in physical activity increased leisure-time cold exposure, and young women were more exposed than older ones. Self-rated health was positively associated with leisure time cold exposure in men and only to a minor extent in women. In conclusion, the subjects reported spending 4% of their total time under cold exposure, most of it (71%) during leisure time. Both occupational and leisure-time cold exposure is greater among men than women.

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