Manifestations of cold sensitivity - a case series

Cold sensitivity among female clinical nurses in Japan: A nationwide study

Objectives

This study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan.

Design

A cross-sectional post survey research design.

Settings

The questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan.

Participants

1,138 female nurses.

Methods

The survey captured participants' characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits.

Results

Of the respondents, 44.3 % were aware of daily cold sensitivity and 21.4 % had a cold sensitivity disorder. The majority of respondents (63.1 %) felt cold in their hands when providing nursing care, and 28.1 % felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30 % of the respondents experienced discomfort owing to cold hands.

Conclusions

The study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.

Neurosensory and vascular symptoms and clinical findings in the hands of Arctic open-pit miners in Sweden and Norway - a descriptive study

This cross-sectional study aimed to describe exposure to cold climate and hand-arm vibration (HAV) as well as neurosensory and vascular symptoms and clinical findings among open-pit Arctic miners. It was based on data from questionnaires and physical examinations, including 177 men and 75 women from two open-pit mines in Sweden and Norway (response rate 54%). Working outdoors or in an unheated building or machine for at least two hours per day was reported by 44% and HAV exposure of the same duration by 10%. Neurosensory symptoms (e.g. reduced perception of touch) in the hands were reported by 47% and Raynaud's phenomenon by 14%. In brief conclusion, the study showed that Arctic miners were commonly exposed to both cold temperatures and HAV. They also reported a broad range of neurosensory and vascular symptoms in their hands and had abnormal clinical findings related to the symptoms. The results emphasise the need for additional preventive measures in this occupational setting.

Microcirculatory response to cold stress test in the healthy hand

OBJECTIVE

Cold sensitivity of the fingers is common in several conditions. It has been linked to digital vasospasm, microvascular dysfunction, and neural mechanisms. This study aimed to investigate the normal digital microvascular response to a cold stress test in healthy individuals using Laser Speckle Contrast Imaging (LSCI).

METHODS

Twenty-six healthy individuals, mean age 31 (SD 9) years were included. Skin perfusion of digits II-V was measured using Laser Speckle Contrast Imaging before and after a standardized cold stress test. Changes in skin perfusion from baseline were analyzed between hands, digits, and sexes.

RESULTS

Skin perfusion was significantly (p < 0.0001) affected by cold provocation in both the cold exposed and the contralateral hands in all participants of the study. This effect was significantly different between the radial (digit II and III) and the ulnar (digit V) side of the hands (p < 0.001). There was a trend towards a larger decrease in perfusion in men (ns), and a faster recovery to baseline values in women (ns). A larger inter subject variability was seen in perfusion values in women.

CONCLUSIONS

The normal microvascular response to cold provocation may involve both centrally and regionally mediated processes. When exposing one hand to a cold stress test, the contralateral hand responds with simultaneous but smaller decreases in perfusion.

Defining abnormal cold sensitivity using the Cold Intolerance Symptom Severity questionnaire: a population study

Cold sensitivity, a common and disabling sequela of hand injury, can be assessed using the Cold Intolerance Symptom Severity (CISS) questionnaire, rating symptoms on a scale from 4 to 100. The primary objective of this study was to define a clinical cut-off for abnormal cold sensitivity based on the CISS score in a healthy working-age population. The secondary objective was to investigate how age, gender and previous injuries and diseases influence CISS scoring. In this study, 1239 out of 1582 selected healthy subjects of working age living in northern Sweden completed the questionnaire, yielding a response rate of 78%. The 95th percentile for the CISS score was 49.5 for men and 53.0 for women. The effects of age, gender and previous injuries and diseases were minor and not considered clinically relevant. The results support that a CISS score above 50 should be considered as abnormal cold sensitivity.Level of evidence: III.