title: Back and neck pain due to working in a cold environment: a cross-sectional study of male construction workers.
abstract: OBJECTIVE
  To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Outdoor work in a cold environment may increase the risk of low back and neck pain.
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden, lage.burstrom@envmed.umu.se.
authors.forename: Lage
authors.initials: L
authors.lastname: Burström
authors.forename: Bengt
authors.initials: B
authors.lastname: Järvholm
authors.forename: Tohr
authors.initials: T
authors.lastname: Nilsson
authors.forename: Jens
authors.initials: J
authors.lastname: Wahlström
mesh_terms: D000328:Adult; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology*; D001696:Biomechanical Phenomena; D003080:Cold Temperature / Q000009:adverse effects*; D060389:Construction Industry; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D017132:Workplace