Cold injuries are rare but important causes of hospitalization. We aimed to identify the magnitude of cold injury hospitalization, and assess causes, associated factors and treatment routines in a subarctic region.
In this retrospective analysis of hospital records from the 4 northernmost counties in Sweden, cases from 2000-2007 were identified from the hospital registry by diagnosis codes for accidental hypothermia, frostbite, and cold-water drowning. Results were analyzed for pre-hospital site events, clinical events in-hospital, and complications observed with mild (temperature 34.9 - 32°C), moderate (31.9 - 28°C) and severe (
Cites: Resuscitation. 2000 Feb;43(3):22310711494
Cites: Aviat Space Environ Med. 2000 Jul;71(7):733-5210902937
Cites: Wien Klin Wochenschr. 2002 May 15;114(8-9):315-2012212366
Cites: Int J Circumpolar Health. 2002 Nov;61(4):352-6212546193
Cites: CMAJ. 2003 Feb 4;168(3):305-1112566336
Cites: High Alt Med Biol. 2003 Spring;4(1):99-10312713717
Cites: Aviat Space Environ Med. 2003 May;74(5):564-7012751587
We examined the severity of airway obstruction and the occurrence of respiratory symptoms in a large, nationally representative population sample and in a subgroup of subjects with chronic bronchitis and/or emphysema to obtain information for developing national prevention and treatment strategies for these diseases. The study population comprised of 7217 randomly selected subjects (aged 30 years and older) who participated in a comprehensive health examination survey. The 'cases' were subjects diagnosed as having chronic bronchitis and/or emphysema. The survey methods comprised of questionnaires, interviews, physical measurements, including spirometry, and clinical examinations. In the whole study population, the age-adjusted prevalence of chronic bronchitis and/or emphysema was 22% among men and 7% among women, whilst clinically relevant airways obstruction (FEV1/FVC%
Fighter pilots who are frequently exposed to severe cold ambient temperatures experience neck pain disabilities and occupational disorders more often than those who are not so exposed. We hypothesized that a cold-induced increase in muscle strain might lead to in-flight neck injuries. The aims of this study were to measure the level of cooling before takeoff and to determine muscle strain under Gz loading (0 to +4 Gz) at different temperatures.
Test subjects' (n = 14) skin temperature (T(skin)) over the trapezoids was measured before the walk to the aircraft and again in the cockpit (air temperature -14 degrees C). The subjects then performed trampoline exercises in two different ambient temperatures (-2 degrees C and +21 degrees C) after a 30-min period at the respective temperatures. EMG activity of the sternocleidomastoid (SCM), cervical erector spinae (CES), trapezoid (TRA), thoracic erector spinae (TES) muscles, and Tskin of the SCM and TRA were measured.
Tskin over the trapezoids decreased from 30.1 +/- 1.7 degrees C to 27.8 +/- 2.6 degrees C (p
Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Respiratory Medicine Unit, Department of Medicine, Oulu University Hospital, FI-90029 Oulu, Finland; Medical Research Center Oulu, Oulu, Finland.
The occurrence of cold temperature-related symptoms has not been investigated previously in young adults, although cold weather may provoke severe symptoms leading to activity limitations, and those with pre-existing respiratory conditions may form a susceptible group. We tested the hypothesis that young adults with asthma and allergic rhinitis experience cold-related respiratory symptoms more commonly than young adults in general.
A population-based study of 1623 subjects 20-27 years old was conducted with a questionnaire inquiring about cold weather-related respiratory symptoms, doctor-diagnosed asthma and rhinitis, and lifestyle and environmental exposures.
Current asthma increased the risk of all cold weather-related symptoms (shortness of breath adjusted PR 4.53, 95% confidence interval 2.93-6.99, wheezing 10.70, 5.38-21.29, phlegm production 2.51, 1.37-4.62, cough 3.41, 1.97-5.87 and chest pain 2.53, 0.82-7.79). Allergic rhinitis had additional effect especially on shortness of breath (7.16, 5.30-9.67) and wheezing (13.05, 7.75-22.00), some on phlegm production (3.69, 2.49-5.47), but marginal effect on cough and chest pain.
Our study shows that already in young adulthood those with asthma, and especially those with coexisting allergic rhinitis, experience substantially more cold temperature-related respiratory symptoms than healthy young adults. Hence, young adults with a respiratory disease form a susceptible group that needs special care and guidance for coping with cold weather.
In the northern hemisphere people are exposed recurrently to cold air and asthmatics experience more respiratory symptoms. We hypothesized that subjects with poor asthma control are more prone to experience cold weather-related respiratory symptoms than those with good asthma control.
A population-based cross-sectional study of 1995 adult asthmatics (response rate 40.4%) living in the Northern Finland was conducted using a questionnaire where cold weather-related respiratory symptoms as well as questions related to asthma control were inquired. The Asthma Control Test (ACT) was defined based on five questions (disadvantage and occurrence of asthma symptoms, waking up because of asthma symptoms, use of rescue medication and self-assessment of asthma control during the past 4 weeks), and was divided into quartiles.
Cold weather-related respiratory symptoms were more frequent among asthmatics with poorly controlled asthma (ACT Q1 vs. ACT Q4); adjusted prevalence ratio (PR) for shortness of breath (men 1.47, 95% confidence interval 1.22-1.77; women 1.18, 1.07-1.30), cough (men 1.10, 0.91-1.34; women 1.18, 1.08-1.30), wheezing (men 1.91, 1.31-2.78; women 1.48, 1.17-1.87), phlegm production (men 1.51, 1.06-2.14; women 1.62, 1.27-2.08) and chest pain (men 4.47, 1.89-10.56; women 2.60, 1.64-4.12). The relations between asthma control and symptom occurrence seemed stronger among smokers than never smokers and subjects with body mass index (BMI) below and above 25-30.
Our study provides new evidence that subjects whose asthma is poorly controlled are more prone to experience cold weather-related respiratory symptoms and even a slight worsening of asthma control increases symptom prevalences.
Cold-induced peripheral neuropathy has been described in individuals exposed to severe cold resulting in pain, hypersensitivity to cold, hyperhidrosis, numbness, and skin changes. Nerve conduction studies and thermal detection thresholds are abnormal in symptomatic patients, and intraepidermal nerve fiber density (IENFD) in skin biopsies is reduced.
A 41-year-old male was included as a healthy subject in a study of the spontaneous variability of quantitative sensory testing (QST), nerve conduction studies (NCS), and IENFD. Unexpectedly, IENFD was significantly reduced, whereas the rest of the examination was normal except for reduced vibration detection threshold. The results were confirmed at follow-up examination. The subject had been repeatedly exposed to severe cold resulting in short lasting numbness and paresthesia while living in the eastern part of Greenland and the northern part of Norway.
Loss of intraepidermal nerve fibers caused by exposure to severe cold may be asymptomatic, and their function assessed by thermal detection thresholds may be preserved. This case illustrates that QST and IENFD are complementary tests and that subclinical cold-induced peripheral neuropathy may be prevalent in subjects living in or near polar regions which could have implications for the recruitment of healthy subjects.
INTRODUCTION: Cold habituation could affect sympatho-vagal balance, which modulates cold stress responses. The study examined cardiovascular autonomic function at the sinus node level during controlled breathing and while undertaking isometric exercise during whole-body cold exposure before and after cold acclimation. METHODS: There were 10 male subjects who were exposed to control (25 degrees C) and cold (10 degrees C) environments for 2 h on 10 successive days in a laboratory. Time and frequency domain heart rate variability (HRV) in terms of root mean square of successive differences in RR intervals, total, high, and low frequency power were determined from controlled breathing at the beginning and end of cold acclimation. Heart rate and blood pressure during an isometric handgrip test (30% MVC for 3 min) were recorded at the beginning and end of cold acclimation. Catecholamines (NE and E), mean skin (Tsk), and rectal temperatures (Trect) were measured. RESULTS: Acute cold exposure increased total (36%), low (16%), and high frequency power (25%) and RMSSD (34%). Cold acclimation resulted in higher Tsk (0.6 degrees C) and lower NE (24%) response in cold. The cold-induced elevation in high frequency power became significant after cold acclimation, while other HRV parameters remained unchanged. A smaller increase in heart rate and blood pressure occurred at 10 degrees C during the handgrip test after cold acclimation. DISCUSSION: Cold exposure increased sympathetic activity, which was blunted after cold acclimation. Parasympathetic activity showed a minor increase in cold, which was enhanced after cold acclimation. In conclusion, cold habituation lowers sympathetic activation and causes a shift toward increased parasympathetic activity.
To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.
This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine.
The prevalence's of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52-1.66) and 1.39 (95 % CI 1.30-1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature.
Outdoor work in a cold environment may increase the risk of low back and neck pain.
Cancer incidence is inexplicably high in cold countries. This has been revealed by recent genetic and epidemiological studies. These studies used data from the GLOBOCAN-2012 database, for 186 populations and for a variety of cancer types. Cancer incidence in Nordic people is particularly high for the frequent cancer forms, like breast, prostate and colon cancer. A relationship of cancer with cold is suspected since Inuit and Alaska Indians that live in even more extreme low temperatures have the higher cancer rates in the world. In this article, possible reasons for this phenomenon are discussed. These explanations are related with: evolutionary adaptation to extreme cold, the genetic background of Nordic people, the experimentally proven fast growth and metastasis of tumors at low temperatures, high concentration of certain air pollutants at cold environments, low levels of serum Vitamin D, overdiagnosis by the medical doctors and high quality of the health system in Nordic countries. Lifestyle parameters are not discussed in detail, although these may be equally crucial for cancer risk in cold countries. In conclusion, more studies are needed to elucidate the real causes of this epidemiological pattern.