Typically, industry workers are exposed to, and may touch, either accidentally or intentionally, many surfaces of different materials (e g machine parts, walls etc.) For environments containing hot surfaces, standards are available to determine the temperature limits for these surfaces in order to minimise safety risks (skin bums, EN 563 1994). However, no such standard is available for cold surfaces and for those working in such a cold environment, accidental skin contact exposure and the resultant skin cooling could pose a health and safety risk in terms of discomfort, pain, numbness and skin damage Data was collected for the derivation of a cold surfaces safety standard (European Union project SMT4-CT97-2149), providing a relation between material type, surface temperature and risk of pain and frostbite for the index fingertip of the non-dominant hand, the overall aim being to use the data to develop a predictive model of fingertip contact cooling allowing the prediction for various materials, temperatures and body thermal states within and outside the actual tested ranges.

Abstract Frostbite of the face and ears is a common problem in cold winters. Application of an emollient on the face is a traditional way to prevent frostbite in Finland. The preliminary results of an epidemiological study on frostbite in Finnish conscripts unexpectedly showed that the use of cold protecting emollients increased the risk of facial frostbite. This finding motivated studies on the effects and use of cold protecting emollients. 830 male Finnish conscripts answered a questionnaire concerning the use of cold protecting emollients, subjective experience of using them in cold and cumulative incidence of frostbite in the ears and face. Risk factors of frostbite were investigated in a prospective epidemiological study including 913 Finnish conscripts needing medical attention for frostbite of the ears or face and their 2478 matched, uninjured controls. Thermal properties of four different emollients were studied in vitro with a skin model and in vivo in experimental cold exposures of test persons. Test emollient was applied on one half of the face, as the other half acted as control. The skin temperatures of the face-halves were compared symmetrically by thermistors and infrared thermography. Subjective sensation of thermal half-difference was also registered. 21% of the conscripts had used emollients in the cold, a majority with an experience of protection. 47% of the conscripts had had frostbite in the head (42% in the ears and 23% on the face). There was a statistically significant correlation between the use of emollients and the incidence of facial frostbite in both epidemiological studies. Applying protective emollients formed an independent risk factor for frostbite of the cheeks, nose and ear lobes (odds ratios 3.3-5.6). The thermal insulation of test emollients on the skin model was minimal. On living skin, the applied half was somewhat cooler in a majority of comparisons. However, white petrolatum gave often a subjective perception of a warming effect. False sensation of safety may form the principal cause for the increased risk of frostbite associated with the use of emollients. When the warning symptoms of cold are weak, necessary protective measures are not carried out.

Background: Myths, misconceptions and a general lack of information surround the use of gloves and mittens in extreme cold environments. Objective. This study assessed how well an assortment of gloves and mittens performed in a very cold environment. Methods. A convenience sample of gloves and mittens were tested in Antarctica during the winter of 2016 using a calibrated thermometer (range: -148 degrees F to +158 degrees F/-1008C to +70 degrees C) three times over a 0.5-mile distance (similar to 20 minutes). A small sensor on a 10-foot-long cable was taped to the radial surface of the distal small finger on the non-dominant hand. The tested clothing was donned over the probe, the maximum temperature inside the glove/mitten was established near a building exit (ambient temperature approximately 54 degrees F/12 degrees C), and the building was exited, initiating the test. The hand was kept immobile during the test. Some non-heated gloves were tested with chemical heat warmers placed over the volar or dorsal wrist. Results. The highest starting (96 degrees F/36 degrees C) and ending (82 degrees F/28 degrees C) temperatures were with electrically heated gloves. The lowest starting temperature was with electrically heated gloves with the power off (63 degrees F/17 degrees C). Non-heated gloves with an inserted chemical hand warmer had the lowest minimum temperature (33 degrees F/1 degrees C). Maximum temperatures for gloves/mittens did not correlate well with their minimum temperature. Conclusions. Coverings that maintained finger temperatures within a comfortable and safe range (at or above 59 degrees F/15 degrees C) included the heated gloves and mittens (including some with the power off) and mittens with liners. Mittens without liners (shell) generally performed better than unheated gloves. Better results generally paralleled the item's cost. Inserting chemical heat warmers at the wrist increased heat loss, possibly through the exposed area around the warmer.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13535号 / 論医博第2275号 / 新制||医||1065(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊達 洋至, 教授 湊谷 謙司, 教授 小林 恭 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Background In Swedish working life, exposure to cold and exposure to hand-arm vibration (HAV) are two common health hazards. Health effects of HAV in the neurosensory, vascular and musculoskeletal systems are collectively denoted hand-arm vibration syndrome (HAVS), and have been thoroughly studied. Effects of cold exposure in terms of effects on the peripheral neurosensory and vascular system are on the contrary limited, especially in an occupational setting. Effects of cold exposure or cold injury have not previously been assessed with quantitative sensory testing (QST). Commonly reported symptoms after exposure to HAV and after cold injuries, includes cold sensitivity and sensation of cold. Cold sensitivity can also occur without previous exposure to vibration or cold and may have a major impact on quality of life. Other possible risk factors for cold sensitivity need to be assessed. Sensation of cold hands could theoretically imply an early manifestation of damage to the neurosensory or vascular system, and therefore be of importance to enable early detection of vascular and neurosensory HAVS. The purpose of this thesis was to increase the knowledge about health effects from cold and HAV on the peripheral neurosensory and vascular system, with an occupational perspective. The aims were: first, to identify and evaluate health effects and sequelae in the peripheral neurosensory and vascular system due to cold injury and cold exposure; second, to investigate if sensation of cold hands is a predictor for future onset of Raynaud's phenomenon or paresthesia; and third, to identify possible risk factors associated with cold sensitivity. Methods A case series on 15 military conscripts with local cold injuries in the hands or feet, involving QST and symptom descriptions, was conducted to investigate the hypothesis that cold injuries can result in similar neurosensory and vascular impairments as in HAVS. To assess health effects of cold exposure, a cohort study on 54 military conscripts in cold winter military training, with cold exposure assessments, was conducted. Possible health effects were assessed after 14 months of military training, containing considerable cold exposure, by means of QST, Finger systolic blood pressure after local cooling (FSBP) and a questionnaire. To investigate if sensation of cold hands is a predictor for vascular or neurosensory HAVS we investigated a cohort of 178 employees at a manufacturing company where HAV was a common exposure. The cohort was followed during 21 years and both vibration exposure and health outcomes were assessed regularly. Questionnaire items were used to assess sensations of cold hands as well as signs of Raynaud’s phenomenon and paresthesia. To identify risk factors for cold sensitivity a case-control study was conducted involving 997iiiparticipants from the general population in northern Sweden. The study was cross-sectional and explored possible risk factors for cold sensitivity. Results Cold injuries and cold exposure were associated with reduced sensibility in QST and increase severity and prevalence of neurosensory and vascular symptoms. Our results did not show any impairment in peripheral blood flow due to cold exposure, detectable by FSBP. The risk of developing Raynaud's phenomenon was increased for workers previously reporting sensation of cold hands (OR 6.3, 95% CI 2.3-17.0). No increased risk for paresthesia in relation to a sensation of cold hands was observed. The identified risk factors for cold sensitivity were frostbite in the hands, rheumatic disease, nerve injury in upper extremities or neck, migraine and vascular disease. When analysing women and men separately, women’s risk factors were frostbite in the hands, rheumatic disease, migraine and cold exposure. Men’s risk factors were frostbite in the hands, vibration exposure and nerve injury in upper extremities or neck. BMI > 25 was a protective factor for both men and women. Conclusion Cold injury and cold exposure are associated with impairments in the neurosensory system, detectable by QST. Symptoms such as sensation of cold hands and white fingers indicate vascular involvement, even though no vascular impairments due to cold exposure could be detected by objective measurements. A sensation of cold hands is a risk factor for development of Raynaud´s phenomenon, but not for paresthesia. At the individual level, reporting cold hands does not appear to be useful information when considering the possibility of a future development of Raynaud’s phenomenon. Frostbite in the hands is a risk factor for cold sensitivity among both women and men. For women rheumatic disease, migraine and cold exposure are also independent risk factors, and for men, exposure to HAV. Being overweight is a protective factor for both women and men.