Subjective Symptoms among Female Workers and Winter Working Conditions in a Consumer Cooperative

Cold-related pain in the face, upper limbs, and lower body among Thai chicken industry workers: a cross-sectional study

OBJECTIVE

There is limited information on cold-related pain (CRP) in various parts of the body among workers employed in cold environments. We, therefore, determined the prevalence of CRP among Thai chicken industry workers and attempted to identify vulnerable subgroups.

METHODS

Four hundred and twenty-two workers in four chicken meat factories in Thailand were asked about CRP in the face, upper limbs, and lower body. The results were expressed as adjusted prevalence and prevalence differences [PD; in percentage points (pp)] and their 95% confidence intervals (CI).

RESULTS

Overall, 80% of the subjects suffered from CRP in at least one site on the body: 66% in the upper limbs, 65% in the lower body, and 44% in the face. In most sites, CRP increased from the lowest to the highest educational level, notably in the nose with a PD of 36 pp [95% CI 23, 49]. Forklift drivers experienced knee pain [PD 21 pp (0, 41)], and manufacturing [PD 27 pp (15, 38)] and storage workers [PD 24 pp (10, 37)] experienced thigh pain more often than office workers, while office workers reported CRP in the cheeks, ears, wrists, and fingers more often than other workers. Women had more CRP than men in several body sites.

CONCLUSIONS

The majority of workers suffered from CRP. Intensified protective measures should be targeted not only for forklift drivers and storage and manufacturing workers, but also for the highly educated as well as the office staff who showed excessive prevalence of CRP in several body sites.

Socioeconomic and behavioural risk factors for adverse winter health and social outcomes in economically developed countries: a systematic review of quantitative observational studies

BACKGROUND

Mortality and morbidity rates are often highest during the winter period, particularly in countries with milder climates. A growing body of research has identified potential socioeconomic, housing and behavioural mediators of cold weather-related adverse health and social outcomes, but an inclusive systematic review of this literature has yet to be performed.

METHODS

A systematic review, with narrative synthesis, of observational research published in English between 2001 and 2011, which quantified associations between socioeconomic, housing or behavioural factors and cold weather-related adverse health or social outcomes.

RESULTS

Thirty-three studies met the inclusion criteria. Average study quality was not high. Most studies failed to control for all relevant confounding factors, or to conduct research over a long enough period to ascertain causality. Low income, housing conditions and composite fuel poverty measures were most consistently associated with cold weather-related adverse health or social outcomes.

CONCLUSIONS

This review identified socioeconomic, housing and behavioural factors associated with a range of cold weather-related adverse health or social outcomes. Only tentative conclusions can be drawn due to the limitations of existing research. More robust studies are needed to address the methodological issues identified and uncover causal associations. A review of qualitative and intervention studies would help to inform policies to reduce the adverse health and social impacts of cold weather.

Subjective symptoms of female workers sorting goods in summer

Subjective musculoskeletal symptoms are more frequently complained about in cold store work and in related conditions than those experienced in normal temperature work. This cross sectional study was undertaken to evaluate the effects of indoor cooling and cold storage goods on the prevalence of subjective symptoms in summer. Female workers sorting cold storage goods (exposed group) were the main subjects of this study (n=47). We also included a group of female workers engaged sorting dry goods as the unexposed to cold group (n=86). Work load for the two groups were estimated according to the recommended criteria. A self-administered questionnaire covering age, occupational career, smoking, alcohol drinking and physical exercise, present or past history of diseases, individual protective measures against cold or heat, and subjective symptoms (60 items) was used. The air temperature of the site at the start of working time for the workers sorting cold storage goods was 22.2℃ which was significantly lower than those measured for the other two work places (25.4℃ and 25.4℃) of the unexposed to cold group. Environmental temperatures at the foot level at the sorting workshop of cold storage goods and dry goods were ca.16℃ and 26℃ all day, respectively. The surface temperatures of cold storage goods were between -2.8℃ and 9.4℃. The surface temperature of dry goods was 26.5℃. Among the working characteristic items, only daily working hours in the exposed group (5.6 ± 0.6 h) were significantly longer than those in the unexposed to cold group (4.6 ± 0.9 h) (p<0.01). The prevalence rates of finger cold sensation, stiffness in the fingers, pain in the wrist, pain in the elbow, back dullness, back pain, low-back cold sensation, foot cold sensation and pain in the foot in the exposed group were significantly higher than those in the unexposed to cold group (p<0.05 or p<0.01). Pain in the fingers, numbness in the fingers, pain in the foot and foot numbness due to the cold in the exposed group were significantly higher than those in the unexposed to cold group (p<0.05 or p<0.01). These results suggest that indoor cooling and/or job activities related to cold storage goods could, to some extent, affect peripheral circulatory disturbances; and it could be regarded as a factor related to musculoskeletal symptoms among the exposed workers.

Subjective musculoskeletal symptoms in winter and summer among indoor working construction electricians

To evaluate the effects of cold exposure on the musculoskeletal system, two surveys on the subjective musculoskeletal symptoms among male electricians working in the buildings under construction were performed in winter (N=74) and summer seasons (N=83). A self-administered questionnaire was used to collect information on age, occupational career, working habit, present illness, and subjective musculoskeletal symptoms. Mean age, occupational career and daily smoking of the supervisors were significantly higher than those of the other subjects. In general, prevalence rates of stiffness, numbness, pain and Raynaud's phenomenon in the fingers, finger cold sensation, dull movement of the fingers, pain in the wrist, knee joint pain, pain and numbness in the foot and foot cold sensation in winter were significantly higher than those in summer. These results were marked especially in the workers except supervisors. In winter, there were no significant differences in the prevalence rates of subjective musculoskeletal complaints between the supervisors and the other workers. On the other hand, in summer, prevalence of stiffness and pain in the shoulder, stiffness and pain in the neck, dullness and pain in the arm, finger cold sensation, low back dullness and low back pain in the supervisors were significantly higher than those in the other workers. These results suggest that effects of cold on the musculoskeletal symptoms markedly appeared in the workers except supervisors.

Health problems in cold work

Cold in- and outdoor work can result in different adverse effects on human health. Health problems decrease performance and work productivity and increase the occurrence of accidents and injuries. Serious health problems can also result in absence from work due to sick leave or hospitalization. At its worst, work in cold conditions could be associated with deaths due to cold-related accidents or a sudden health event. Musculoskeletal complaints, like pain, aches etc. are common in indoor cold work. Breathing cold air while working may lead to respiratory symptoms, which can decrease performance in cold. The symptoms are usually worsened by exercise and ageing, being more common in persons having a respiratory disease. Cardiovascular complaints and related performance decrements could be especially pronounced during work in cold weather and involving physical exercise, especially among those with an underlying cardiovascular disease. The article also reviews the current information related to diabetes, skin disorders and diseases, as well as cold injuries and accidents occurring in cold work. Increasing awareness and identifying workplace- and individual-related cold risks is the first step in proper cold risk management. Following this, the susceptible population groups need customized advice on proper prevention and protection in cold work.