Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study

Stjernbrandt, Albin; Björ, Bodil; Andersson, Martin; Burström, Lage; Liljelind, Ingrid; Nilsson, Tohr; Lundström, Ronnie; Wahlström, Jens

doi:10.1007/s00420-017-1221-3

Cited by 26 publications

(45 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study sample was randomly selected from the national Swedish population register. The rationale and methodology for the CHINS1 study have previously been described in detail (Stjernbrandt et al 2017 ).…”

Section: Methodsmentioning

confidence: 99%

“…Swedish national statistics from 2015 report that 23% of working men and 14% of working women in Sweden are occupationally exposed to an ambient cold climate for at least one quarter of their working hours (Swedish Work Environment Authority 2016 ). During leisure-time, 30% of men, and 25% of women, living in Northern Sweden, report a high cold exposure (Stjernbrandt et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

Stjernbrandt

Carlsson

Pettersson

et al. 2018

Int Arch Occup Environ Health

Self Cite

View full text Add to dashboard Cite

PurposeTo identify factors associated with the reporting of cold sensitivity, by comparing cases to controls with regard to anthropometry, previous illnesses and injuries, as well as external exposures such as hand–arm vibration (HAV) and ambient cold.MethodsThrough a questionnaire responded to by the general population, ages 18–70, living in Northern Sweden (N = 12,627), cold sensitivity cases (N = 502) and matched controls (N = 1004) were identified, and asked to respond to a second questionnaire focusing on different aspects of cold sensitivity as well as individual and external exposure factors suggested to be related to the condition. Conditional logistic regression analyses were performed to determine statistical significance.ResultsIn total, 997 out of 1506 study subjects answered the second questionnaire, yielding a response rate of 81.7%. In the multiple conditional logistic regression model, identified associated factors among cold sensitive cases were: frostbite affecting the hands (OR 10.3, 95% 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); migraines (OR 2.4, 95% CI 1.3–4.3); and vascular disease (OR 1.9, 95% CI 1.2–2.9). A body mass index ≥ 25 was inversely related to reporting of cold sensitivity (0.4, 95% CI 0.3–0.6).ConclusionsCold sensitivity was associated with both individual and external exposure factors. Being overweight was associated with a lower occurrence of cold sensitivity; and among the acquired conditions, both cold injuries, rheumatic diseases, nerve injuries, migraines and vascular diseases were associated with the reporting of cold sensitivity.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

Stjernbrandt

Carlsson

Pettersson

et al. 2018

Int Arch Occup Environ Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…The study sample was selected from the national Swedish population register. The data collection has previously been thoroughly described [6].…”

Section: Participantsmentioning

confidence: 99%

Raynaud’s phenomenon in Northern Sweden: a population-based nested case–control study

et al. 2018

Self Cite

View full text Add to dashboard Cite

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 handarm 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.

show abstract

“…Through a large, questionnaire-based epidemiological research project called Cold and Health in Northern Sweden (CHINS), subjects experiencing CS (N = 504) were identified [7,28]. First, an information letter was sent to possible study subjects, living in the municipalities closest to the clinic.…”

Section: Study Subjectsmentioning

confidence: 99%

“…Those who did not participate either declined after initial information (N = 11), could not be reached (N = 5), or had moved from the study region (N = 2). In addition, one extra CS case was recruited as a first-degree relative to one of the CHINS subjects and was asked to complete the original CHINS questionnaires [7,28] during the clinic visit, in which the case definition was fulfilled. The final study population consisted of eight women and four men, with a median age of 53 years (IQR 9; range 22-74).…”

Section: Recruitmentmentioning

confidence: 99%

Manifestations of cold sensitivity – a case series

Stjernbrandt

Björ

Pettersson

et al. 2020

International Journal of Circumpolar Health

Self Cite

View full text Add to dashboard Cite

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 and examined 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 dyshomogeneous perfusion 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.

show abstract

Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study

Cited by 26 publications

References 25 publications

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden

Raynaud’s phenomenon in Northern Sweden: a population-based nested case–control study

Manifestations of cold sensitivity – a case series

Contact Info

Product

Resources

About