Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
Int Arch Occup Environ Health. 2022 Nov;95(9):1871-1879. doi: 10.1007/s00420-022-01884-2. Epub 2022 May 31.
To determine if occupational exposure to cold environments is associated with incident airway symptoms in previously healthy workers.
A prospective, survey-based, closed-cohort study was conducted on a sample of 5017 men and women between 18 and 70 years of age, living in northern Sweden. Data on occupation, occupational and leisure-time cold exposure, airway symptoms, general health, and tobacco habits were collected during the winters of 2015 (baseline) and 2021 (follow-up). Stepwise multiple logistic regression was used to determine associations between baseline variables and incident airway symptoms.
For individuals working at baseline, without physician-diagnosed asthma or chronic obstructive pulmonary disease, reporting any occupational cold exposure was associated with incident wheeze (OR 1.41; 95% CI 1.06-1.87) and incident productive cough (OR 1.37; 95% CI 1.06-1.77), but not incident long-standing cough (OR 0.98; 95% CI 0.74-1.29), after adjusting for age, body mass index, daily smoking, and occupational physical workload. Detailed analysis of the occupational cold exposure rating did not reveal clear exposure-response patterns for any of the outcomes.
Occupational cold exposure was robustly associated with incident wheeze and productive cough in previously healthy workers. This adds further support to the notion that cold air is harmful for the airways, and that a structured risk assessment regarding occupational cold exposure could be considered for inclusion in the Swedish workplace legislation. Further studies are needed to elaborate on exposure-response functions, as well as suggest thresholds for hazardous cold exposure.
确定职业性冷暴露是否与先前健康工人的气道症状发生有关。
在瑞典北部，对年龄在 18 至 70 岁之间的 5017 名男性和女性进行了一项前瞻性、基于调查的封闭队列研究。在 2015 年（基线）和 2021 年（随访）的冬季，收集了关于职业、职业和休闲时间冷暴露、气道症状、一般健康状况和吸烟习惯的数据。采用逐步多因素逻辑回归来确定基线变量与新发气道症状之间的关联。
对于基线时没有医生诊断的哮喘或慢性阻塞性肺疾病的个体，报告任何职业性冷暴露与新发喘息（OR 1.41；95%CI 1.06-1.87）和新发有痰咳嗽（OR 1.37；95%CI 1.06-1.77）相关，但与新发长期咳嗽（OR 0.98；95%CI 0.74-1.29）无关，调整年龄、体重指数、每日吸烟和职业体力劳动后。对职业性冷暴露评分的详细分析并未显示出任何结局的明确暴露-反应模式。
职业性冷暴露与先前健康工人新发喘息和有痰咳嗽显著相关。这进一步支持了冷空气对气道有害的观点，并且考虑将职业性冷暴露的结构化风险评估纳入瑞典工作场所法规。需要进一步研究来阐述暴露-反应函数，并提出危险冷暴露的阈值。
