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Pienimäki, Tuomo (2002)
Publisher: Co-Action Publishing
Journal: International Journal of Circumpolar Health
Languages: English
Types: Article
Subjects: carpal tunnel syndrome, disc degeneration, joint pain, low back pain, shoulder pain, tenosynovitis
The aim of this study was to investigate how cold exposure may be associated with musculoskeletal problems either on symptomatic or disease level based on available relevant scientific literature.The data collection resulted in ten scientific articles, from which nine were epidemiological and one a case report consisting of three cases. The results indicated that musculoskeletal symptoms are more frequent in cold store work and in related conditions than in normal temperature work and symptoms seems to be increased when the working time in cold environment increases. In cold store work low back pain and knee pain are more frequent problems than in normal temperature working environment. The association between cold exposure and shoulder pain is still unclear and has been poorly studied. Meteorological conditions, principally low ambient temperature may have an effect of reported low back pain in a remarkable part of population. In the etiology of tenosynovitis cold exposure has a specific role either as a causative or a contributing factor. The risk for carpal tunnel disease is 2.2-fold in repetitive wrist movements compared with no repetition and 9.4-fold when cold exposure added. Cold exposure in work seems to be is associated with a little increased risk (Odds ratio 2.2) for degenerative discopathies of lower back in men. However, this risk is small and seems to be associated with other physical factors in the background. In conclusion, the associations between cold exposure and musculoskeletal complaints or diseases are shown in some studies and the need of further research is apparent.(Int J Circumpolar Health 2002; 61(2):173-182)Keywords: carpal tunnel syndrome, disc degeneration, joint pain, low back pain, shoulder pain, tenosynovitis
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    • According to the reviewed ar ticles, the best documenta- 1 . Chen F, Li T, Huang H, Holmer I. A field
    • study of cold effects among cold store tion is that of tenosynovitis as a clinical entity (6, 11). The workers in China. Arct Med Res 1991; 50: case repor t study by Georgitis (6) represents extreme con- Suppl.6: 99-103. ditions as an etiologic factor for extensor tenosynovitis of 2 . Chiang HC, Chen SS, Yu H et al. The
    • occurrence of carpal tunnel syndrome in the hand and the results can be considered relevant and frozen food factory employees. Kao Hsiung cold exposure and wind-chill can be considered as a caus- I Hsueh Ko Hsueh Tsa Chih 1990 (6); (2): ative factors for tenosynovitis. In these cases also static 73-80.
    • 3 . Ding YF, Huang JZ, Xu Q et al. Health work of wrists may be a contributing factor. The study by survey of cold store work. Ind Health Kurppa et al. (11) shows the association of increased inci- Occup Dis 1994;20:294-297. dence for tenosynovitis in a colder (8-10 ºC) than in normal 4 . Elsner G, Nienhaus A, Beck W. working temperature.The carpal tunnel syndrome seems to Berufsbedingte degenerative Diskopathien
    • im Lendenwirbelsäulenbereich. Soz be associated with cold exposure (2) in connection with the Präventivmed 1997; 42(3): 144-154. simultaneous high repetitive wrist movements.This combi- 5 . Fredriksson K, Alfredsson L, Koster M, nation makes it difficult to show the single causative propor- Thorbjornsson CB, Toomingas A, Torgen M,
    • Kilbom A. Risk factors for neck and upper tion and the principal mechanism of cold exposure in the limb disorders: results from 24 years of development of CTS. follow up.Occup Environ Med 1999 Jan;
    • Degenerative back diseases are a troublesome and ex- 56(1):59-66.
    • 6 . Georgitis J. Extensor tenosynovitis of the pensive problem in work life in western countries. Degener- hand from cold exposure. J Maine Med ative disc diseases of the low back seem to associate with Assoc 1978 Apr; 69 (4): 129-131. cold exposure in work as an elevated risk in population (4), 7 . Gorin AA, Smyth JM, Weisberg JN, Affleck but the risk is not ver y high and according to the relevant G, Tennen H, Urrows S, Stone
    • AA.Rheumatoid arthritis patients show data the association can be questioned. The risk seems to weather sensitivity in daily life, but the be the same as usual posture-related risk factors for disc relationship is not clinically significant. diseases of the low back. Degenerative back disorders are Pain 1999 May; 81(1-2):173-7.
    • 8 . Hassi J, Gardner L, Hendricks S, Bell J. ver y common and may have also many genetic and trau- Occupational injuries in the mining matic etiologic causes. Heavy work is associated with back industry and their association with pain and degenerative processes and it is possible that statewide cold ambient temperatures in the
    • USA. Am J Ind Med 2000 Jul;38(1):49-58. heavy work in many cases includes also working in difficult 9 . Jin K, Sorock G, Courtney T, Liang Y, Yao Z, conditions as in cold environment. This kind of problem Matz S, Ge L. Risk factors for work-related needs fur ther and greater population-based, prospective low back pain in the People´s Republic of and clinical studies to specify the possible association be- China. Int J Occup Environ Health
    • 2000;6:26-33. tween cold exposure and back problems in work.The rela- 10. Kelsey JL. Epidemiology of musculoskeletal tionship is possible because cold exposure may increase the disorders. Monographs in epidemiology and risk for back injuries such as inter ver tebral disc lesions or biostatistics. Vol 3. Oxford: Oxford
    • University Press, 1982. soft tissue sprains. This can be caused by declined motor 11. Kurppa K, Viikari-Juntura E, Kuosma E, and musculoskeletal performance in cold environment. Huuskonen M, Kivi P. Incidence of However, according to the available scientific data, the tenosynovitis or peritendinitis and
    • epicondylitis in meat-processing factory. weakest association is still between cold exposure and back Scand J Work Environ Health 1991; 17: 32- diseases including also discopathies. Cold exposure may be 37. a contributing factor for injuries in different par ts of the 12. Lapossy E, Gasser P, Hrycaj P, Dubler B, whole musculoskeletal system as proposed in many studies Samborski W, Muller W. Cold-induced
    • vasospasm in patients with fibromyalgia and (8). How impor tant the “cold exposure-musculoskeletal in- chronic low back pain in comparison to jur y-mechanism” is in developing musculoskeletal diseases, is healthy subjects. Clin Rheumatol 1994 Sep;
    • 23(3): 442-445. 13. McGorry RW, Hsiang SM, Snook SH,
    • Spine 1998 Oct 1; 23 (19): 2096-2102. 14. Niedhammer I, Landre M-F, Leclerc A,
    • Environ Health 1998;4:168-178. 15. Pope DP, Croft PR, Pritchard CM, Silman
    • Occup Environ Med 1997; 54: 316-321. 16. Toomingas A, Theorell T, Michelsen H,
    • Work Environ Health 1997 Apr; 23
    • (2):130-9. 17. Wang HC, Li TL, Chen F et al. A health
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