Occupational cold exposure is associated with increased reporting of airway symptoms

Albin Stjernbrandt,Nikolai Stenfors,Ingrid Liljelind

doi:10.1007/s00420-021-01694-y

Albin Stjernbrandt, Nikolai Stenfors + Show 1 more

Open Access

https://doi.org/10.1007/s00420-021-01694-y

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Abstract

ObjectiveTo determine if exposure to cold environments, during work or leisure time, was associated with increased reporting of airway symptoms in the general population of northern Sweden.MethodsThrough a population-based postal survey responded to by 12627 subjects, ages 18–70, living in northern Sweden, the occurrence of airway symptoms was investigated. Cold exposure during work or leisure time was self-reported on numerical rating scales. Binary logistic regression was used to determine the statistical association between cold exposure and airway symptoms.ResultsFor currently working subjects (N = 8740), reporting any occupational cold exposure was associated to wheeze (OR 1.3; 95% CI 1.1–1.4); chronic cough (OR 1.2; 95% CI 1.1–1.4); and productive cough (OR 1.3; 95% CI 1.1–1.4), after adjusting for gender, age, body mass index, daily smoking, asthma, and chronic obstructive pulmonary disease. Leisure-time cold exposure was not significantly associated to reporting airway symptoms.ConclusionsOccupational cold exposure was an independent predictor of airway symptoms in northern Sweden. Therefore, a structured risk assessment regarding cold exposure could be considered for inclusion in the Swedish workplace legislation.

Highlights

Around 4 million people live in the Arctic region (Larsen and Fondahl 2014) and are subjected to a cold climate
A large epidemiological study in Finland reported that wheeze, tightness of breath, cough, and sputum were more prevalent in areas with cold climate, and the highest prevalence of chronic bronchitis was found among smoking outdoor workers (Kotaniemi et al 2002)
To the authors’ knowledge, there have been no previous population-based studies on cold-related respiratory symptoms in northern Sweden, though ambient cold exposure is often profound in this region

Summary

Introduction

Around 4 million people live in the Arctic region (Larsen and Fondahl 2014) and are subjected to a cold climate. Exposure to cold air is associated with increased morbidity and mortality (Rocklöv and Forsberg 2008), especially among the elderly and those with cardiorespiratory disease (Analitis et al 2008; Hajat et al 2007; Näyhä 2005; Schwartz 2005; The Eurowinter Group 1997). Exposure to cold and dry air is associated with increased frequency of airway infections Winter sport endurance athletes, such as cross-country skiers, are repeatedly exposed to cold air during prolonged periods of exercise, and show an increased prevalence of airway symptoms, bronchial hyperreactivity, and asthma (Carlsen et al 2008). The high prevalence of asthma among elite athletes is believed to be related to inhalation of cold and dry air, leading to desiccation of the airways, which induces a hyperosmolar milieu in the airway mucosa. To the authors’ knowledge, there have been no previous population-based studies on cold-related respiratory symptoms in northern Sweden, though ambient cold exposure is often profound in this region

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