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Tekavec E, Nilsson T, Dahlin LB, Huynh E, Axmon A, Nordander C, Riddar J, Kåredal M. Serum biomarkers in patients with hand-arm vibration injury and in controls. Sci Rep 2024; 14:2719. [PMID: 38302542 PMCID: PMC10834969 DOI: 10.1038/s41598-024-52782-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024] Open
Abstract
Hand-arm vibration injury is a well-known occupational disorder that affects many workers globally. The diagnosis is based mainly on quantitative psychophysical tests and medical history. Typical manifestations of hand-arm vibration injury entail episodes of finger blanching, Raynaud's phenomenon (RP) and sensorineural symptoms from affected nerve fibres and mechanoreceptors in the skin. Differences in serum levels of 17 different biomarkers between 92 patients with hand-arm vibration injury and 51 controls were analysed. Patients with hand-arm vibration injury entailing RP and sensorineural manifestations showed elevated levels of biomarkers associated with endothelial injury or dysfunction, inflammation, vaso- or neuroprotective compensatory, or apoptotic mechanisms: intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1); thrombomodulin (TM), heat shock protein 27 (HSP27); von Willebrand factor, calcitonin gene-related peptide (CGRP) and caspase-3. This study adds important knowledge on pathophysiological mechanisms that can contribute to the implementation of a more objective method for diagnosis of hand-arm vibration injury.
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Affiliation(s)
- Eva Tekavec
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 00, Lund, Sweden.
| | - Tohr Nilsson
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden
| | - Lars B Dahlin
- Department of Translational Medicine-Hand Surgery, Lund University, 221 00, Lund, Sweden
| | - Elizabeth Huynh
- Occupational and Environmental Medicine, Region Skåne, 223 63, Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 00, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 00, Lund, Sweden
| | - Jakob Riddar
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 00, Lund, Sweden
| | - Monica Kåredal
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 00, Lund, Sweden
- Occupational and Environmental Medicine, Region Skåne, 223 63, Lund, Sweden
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Stjernbrandt A, Pettersson H, Vihlborg P, Wahlström J, Lewis C. Occupational exposure to whole-body vibration and neck pain in the Swedish general population. ERGONOMICS 2024; 67:136-147. [PMID: 37161844 DOI: 10.1080/00140139.2023.2210792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
The primary aim of this study was to determine if occupational exposure to whole-body vibration (WBV) was associated with reporting neck pain. A cross-sectional study was conducted on a sample of the general population living in northern Sweden, aged 24-76 years. Data was retrieved through a digital survey that collected subjectively reported information on exposure to WBV and biomechanical exposures as well as neck pain. The study included 5,017 participants (response rate 44%). Neck pain was reported by 269 men (11.8%) and 536 women (20.2%). There was a statistically significant association between reporting occupational exposure to WBV half the time or more (adjusted OR 1.91; 95% CI 1.22-3.00) and reporting neck pain. In gender-stratified analyses, the same pattern was observed in men, while there were too few women to determine any association. We conclude that occupational exposure to whole-body vibration was associated with neck pain in men.Practitioner summary: This cross-sectional, survey-based study investigated associations between self-reported occupational whole-body vibration and neck pain. It showed significant associations between frequent exposure to whole-body vibration and neck pain among men but not women. In occupational health care settings, whole-body vibration could be considered as a possible risk factor for neck pain.
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Affiliation(s)
- Albin Stjernbrandt
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Hans Pettersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Per Vihlborg
- Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jens Wahlström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Charlotte Lewis
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
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Kriemler S, Mateikaitė-Pipirienė K, Rosier A, Keyes LE, Paal P, Andjelkovic M, Beidleman BA, Derstine M, Pichler Hefti J, Hillebrandt D, Horakova L, Jean D. Frostbite and Mortality in Mountaineering Women: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2023; 24:247-258. [PMID: 37824760 DOI: 10.1089/ham.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Kriemler, Susi, Kastė Mateikaitė-Pipirienė, Alison Rosier, Linda E. Keyes, Peter Paal, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, and Dominique Jean; for the UIAA MedCom Writing Group on Women's Health in the Mountains. Frostbite and mortality in mountaineering women: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:247-258, 2023. Background: The harsh environment of high altitudes (HA) poses many serious health risks for mountaineers, including cold injuries and death. The aim of this work was to review whether female mountaineers are at special risk for frostbite or death at HA compared with their male counterparts. Methods: The UIAA Medical Commission convened an international author team to review women's health issues at HA and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified with additional publications found by hand search. The primary search focus was for articles assessing cold injuries and death in women mountaineers at HA. Results: We reviewed the literature and identified 20 relevant studies: 2 studies on frostbite at HA, plus 7 studies and 1 report for death at HA. An additional 10 studies about frostbite at low altitude were included. We found that female mountaineers at HA were at lower risk of death than their male counterparts, but sex differences in frostbite were inconclusive. Conclusions: The frequency of cold injuries and mortality in female mountaineers is not yet well studied, and the studies that have been published tend to lack precise exposure data. More studies and registries with sex-differentiated data are needed.
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Affiliation(s)
- Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Alison Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anesthesiology, Perioperative and Intensive Care, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pediatrics, Infectious Diseases, and Altitude Medicine, Grenoble, France
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Stjernbrandt A, Johnsen M, Liljelind I, Aminoff A, Wahlström J, Höper AC, Pettersson H, Nilsson T. Neurosensory and vascular symptoms and clinical findings in the hands of Arctic open-pit miners in Sweden and Norway - a descriptive study. Int J Circumpolar Health 2023; 82:2254916. [PMID: 37669310 PMCID: PMC10481761 DOI: 10.1080/22423982.2023.2254916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/07/2023] Open
Abstract
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.
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Affiliation(s)
- Albin Stjernbrandt
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Ingrid Liljelind
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anna Aminoff
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anje Christina Höper
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Hans Pettersson
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tohr Nilsson
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Yoo J, Cheon M. Dynamic blood flow imaging with 99mTc-hydroxymethylene diphosphonate as a therapeutic response marker in patients with Raynaud's phenomenon. Sci Rep 2023; 13:19751. [PMID: 37957209 PMCID: PMC10643549 DOI: 10.1038/s41598-023-47197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
We evaluated the predictive value of dynamic blood flow scintigraphy with 99mTc-HDP (hydroxymethylene diphosphonate) for therapeutic response in patients with Raynaud's phenomenon (RP). Eighty patients who underwent dynamic blood flow scintigraphy using the one-hand chilling method were enrolled. We analyzed the quantitative variables as the ratio of chilled fingers to ambient fingers (CAfinger), that of the chilled hand to ambient hand (CAhand), and that of chilled fingers to ambient palm (FPR) (CAFPR) at 15 and 30 s after 99mTc-HDP bolus injection. Total cumulative radioactivity counts for 180 s were obtained. We evaluated the clinical utility of these quantitative parameters with other clinical variables, including RP severity, therapeutic compliance, types of RP, and scintigraphic interpretation of findings in patients with RP. Fifty-two patients showed poor therapeutic response. There were significant differences between good- and poor-therapeutic responder groups in RP intensity (p = 0.003), CAfinger15s (p = 0.008), CAfinger30s (p = 0.002), CAfinger180s (p = 0.011), CAhand15s (p = 0.008), CAhand30s (p = 0.007), CAhand180s (p = 0.017), CAFPR30s (p = 0.004), and CAFPR180s (p = 0.002). After multivariate logistic regression analysis, only CAfinger30s (p = 0.002) had an independent predictive value of the therapeutic response. 99mTc-HDP dynamic blood flow scintigraphy could be helpful in predicting the therapeutic response in patients with RP.
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Affiliation(s)
- Jang Yoo
- Department of Nuclear Medicine, Veterans Health Service Medical Center, Seoul, South Korea.
| | - Miju Cheon
- Department of Nuclear Medicine, Veterans Health Service Medical Center, Seoul, South Korea
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Kadian-Dodov D. Cold Hands or Feet: Is It Raynaud's or Not? Med Clin North Am 2023; 107:829-844. [PMID: 37541711 DOI: 10.1016/j.mcna.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
Raynaud's phenomenon is an exaggerated response to cold stimuli that may be primary or secondary. The diagnosis relies on patient history and physical examination to distinguish RP from other vasomotor dysfunction (e.g. acrocyanosis, pernio, small fiber neuropathy with vasomotor symptoms, and complex regional pain syndrome). Achenbach syndrome, or spontaneous venous hemorrhage, may also be mistaken for RP but is a self-limiting phenomenon. Laboratory evaluation and vascular diagnostic testing may identify SRP causes. Regardless of etiology, treatment includes warming with trigger avoidance, and consideration of vasodilators (eg. calcium channel, alpha-1 blockers). SRP with digital ulceration may require PDE5i, endothelin-1 receptor blockers, and prostanoids. Refractory cases may require pneumatic arterial pumps, botulinum toxin administration, or surgical sympathectomy.
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Affiliation(s)
- Daniella Kadian-Dodov
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, 1190 Fifth Avenue, Box 1030, New York, NY 10029, USA.
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Stjernbrandt A, Pettersson H, Wahlström V, Wahlström J, Lewis C. Occupational cold exposure is associated with upper extremity pain. FRONTIERS IN PAIN RESEARCH 2023; 4:1063599. [PMID: 37325674 PMCID: PMC10264621 DOI: 10.3389/fpain.2023.1063599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 05/19/2023] [Indexed: 06/17/2023] Open
Abstract
Background Occupational cold exposure is common in Sweden but potential impacts on musculoskeletal disorders have not been thoroughly investigated. The primary aim of this study was to determine the associations between occupational contact and ambient cooling in relation to pain in the upper extremity. Methods In this cross-sectional study, a digital survey was conducted on a population-based sample of women and men between 24 and 76 years of age, living in northern Sweden. Occupational cold exposure, heavy manual handling, work with vibrating tools as well as the presence of upper extremity pain at different sites were subjectively reported. Associations between exposure and outcome were evaluated using multiple binary logistic regression. Results The final study sample included 2,089 (54.4%) women and 1,754 men, with a mean age of 56 years. Hand pain was reported by 196 (5.2%), lower arm pain by 144 (3.8%), and upper arm pain by 451 (11.9%). Severe ambient cooling for more than half of the working time was statistically significantly associated with hand pain (OR: 2.30; 95% CI: 1.23-4.29) and upper arm pain (OR: 1.57; 95% CI: 1.00-2.47) but not lower arm pain (OR: 1.87; 95% CI: 0.96-3.65) after adjusting for gender, age, body mass index, current daily smoking, heavy manual handling, and work with vibrating tools. Conclusions Occupational cold exposure was statistically significantly associated with hand pain and upper arm pain. Therefore, occupational cold exposure should be recognized as a potential risk factor for musculoskeletal disorders in the upper extremity.
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Lewis C, Stjernbrandt A, Wahlström J. The association between cold exposure and musculoskeletal disorders: a prospective population-based study. Int Arch Occup Environ Health 2023; 96:565-575. [PMID: 36592178 PMCID: PMC10079729 DOI: 10.1007/s00420-022-01949-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/16/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of the study was to determine the association between occupational ambient cold exposure and neck-shoulder pain (NSP), low back pain (LBP), and radiating LBP. METHODS The study cohort comprised of 3,843 working subjects in northern Sweden who answered a baseline (spring 2015) and a follow-up questionnaire (spring 2021). NSP, LBP, and radiating LBP were assessed in both surveys. Occupational cold exposure was assessed at baseline, on a whole number numerical rating scale (NRS) and categorized in quartiles. Binary logistic regression determined the association between cold exposure at baseline and incident NSP, LBP, and radiating LBP, adjusted for age, gender, body mass index, smoking, mental stress, and physical workload. RESULTS There were statistically significant associations between high occupational ambient cold exposure (NRS 5-7 and NRS 8-10) and NSP (1.59; 95% CI 1.08-2.33 and OR 1.50; 95% CI 1.03-2.19); NRS 8-10 and LBP (OR 1.61; 95% CI 1.13-2.29); and NRS 5-7 and radiating LBP (OR 1.87; 95% CI 1.12-3.16). Gender-stratified analyses showed statistically significant associations between high occupational ambient cold exposure (NRS 5-7 and NRS 8-10) and NSP (OR 1.97; 95% CI 1.07-3.61 and OR 1.97; 95% CI 1.06-3.67) for men and between NRS 8-10 and LBP (OR 1.82; 95% CI 1.14-2.91) and NRS 5-7 and radiating LBP (OR 2.20; 95% CI 1.15-4.24) for women. CONCLUSIONS Occupational ambient cold exposure was associated with NSP, LBP, and radiating LBP, and should be recognised as a possible occupational risk factor.
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Affiliation(s)
- Charlotte Lewis
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
| | - Albin Stjernbrandt
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
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