title: Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study.
abstract: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms.
  
  
  
  A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden.
  
  
  
  A total of 12,627 out of 35,144 subjects returned the questionnaire (response rate 35.9%). Subjects living in the rural alpine areas reported more extensive cold exposure both during work and leisure time compared to the urbanized coastal regions. Frostbite in the hands was present in 11.4% of men and 7.1% of women, cold sensitivity was present in 9.7 and 14.4%, and Raynaud's phenomenon was present in 11.0% of men and 14.0% of women. There was a positive association between cumulative cold exposure and neurovascular hand symptoms.
  
  
  
  The present study demonstrates that the cold environment in northern Sweden might be an underestimated health risk. Our hypothesis that cold exposure is positively related to reporting of neurovascular hand symptoms was supported by our findings. In addition, such symptoms were common not only in conjunction with an overt cold injury. Our results warrant further study on pathophysiological mechanisms and suggest the need for confirmatory prevalence studies to support national public health planning.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden. albin.stjernbrandt@umu.se.|Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden. albin.stjernbrandt@umu.se.
authors.forename: Albin
authors.identifier: http://orcid.org/0000-0001-6082-8465
authors.initials: A
authors.lastname: Stjernbrandt
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.|Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Björ
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.|Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Lage
authors.initials: L
authors.lastname: Burström
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.|Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Liljelind
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Tohr
authors.initials: T
authors.lastname: Nilsson
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.|Department of Radiation Sciences, Umeå University, 901 87, Umeå, Sweden.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Lundström
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.|Occupational and Environmental Medicine, University Hospital of Umeå, 901 85, Umeå, Sweden.
authors.forename: Jens
authors.initials: J
authors.lastname: Wahlström
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001110:Arctic Regions / Q000453:epidemiology; D003081:Cold Climate / Q000009:adverse effects*; D000067390:Cold Injury / Q000453:epidemiology*; D015897:Comorbidity; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005627:Frostbite / Q000453:epidemiology; D006225:Hand; D006304:Health Status; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D011928:Raynaud Disease / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Cold exposure; Cold sensitivity; Frostbite; Hand; Raynaud’s phenomenon; Sweden