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. 2022 Sep 1;13:934163. doi: 10.3389/fphys.2022.934163

TABLE 3.

Effect estimates sorted after type and type of assessment of pain or regional pain.

Outcome Exposure Effect estimate (95% CI) Percent having outcome of total sample Numbers of participants Risk of bias Study
Exposed Total
Clinical examination Rotator cuff syndrome Self-reported cold exposure >4 h/day Men Not reported 7.0 149 2,161 11 Bodin et al. (2012)
Women OR 1.3 (0.5–3.5) 9.3 71 1,548
Achilles paratendinitis Winter compared to summer Men RR 2.62 (1.71–4.01)a 6.8 697 1,500 10 Milgrom et al. (2003)
Self-reported pain Any MSC Self-reported working in cold environments ≥25% of the time Both genders IRR 1.15 (1.03–1.29) 55.7 258 2,347 12 Farbu et al. (2021a)
Severe MSC IRR 0.95 (0.60–1.48) 8.4
MSC in ≥3 regions IRR 1.11 (0.83–1.49) 17.6
Any pain Self-reported work in cold environment Both genders OR 1.84 (1.37–2.47) 39.3 323 955 8 Pinar et al. (2013)
Per 10 h/week cold exposure Men OR 1.13 (1.03–1.22) 30.2 n.a 2,332 8 Raatikka et al. (2007)
Women OR 1.35 (1.14–1.58) 27.2 2,840
Pain at 1-2 sites Self-reported working in cold environments ≥25% of the time Both genders OR 0.95 (0.73–1.24) 16.3 623 5493 8 Farbu et al. (2019)
Pain at ≥3 sites OR 1.57 (1.23–2.01) 18.7 666 5657
Low back Working in −20°C compared to >20°C Men OR 2.6 (1.03–6.5) 32.8 64 122 10 Dovrat and Katz-Leurer (2007)
North central Men OR 1.19 (1.14–1.24) 24.3 23 514 118 258 10 Burstrom et al. (2013)
OR 1.09 (1.05–1.13) 57 148
Wet clothes ≥5 h <10°C working environment Men OR 1.54 (1.31–1.81) 51 1,196 3,530 9 Skandfer et al. (2014)
OR 1.81 (1.54–2.14) 1,668
Working in 2°C compared to 8–12°C Men PR 4.48 (1.61–12.4) 9.3 50 112 9 Piedrahí;ta et al. (2004)
Experience of cooling at work Both genders OR 3.22 (2.28–4.55) 70 195 1,117 9 Sormunen et al. (2009)
Slight OR 6.08 (4.01–9.24) 175
Some OR 7.36 (3.99–13.58) 78
Extensive
Per 10 h/week cold exposure Men OR 1.17 (1.04–1.30) 6.7 n.a 2,267 8 Raatikka et al. (2007)
Women OR 1.41 (1.04–1.87) 5.0 2,785
Self-reported working in cold environments ≥25% of the time Both genders OR 1.18 (0.91–1.52) 14.3 779 6,553 8 Farbu et al. (2019)
Self-reported occupational exposure. Lowest tertile as reference Both genders OR 1.10 (0.94–1.29) 14.9 2093 8740 7 Stjernbrandt and Farbu (2022)
Medium (2. tertile) OR 1.38 (1.17–1.63) 1958
High (3. tertile)
Self-reported leisure-time exposure. Categorized into tertiles. Highest compared to lowest Both genders OR 1.01 (0.86–1.18) Not reported Not reported 12 627 7 Stjernbrandt and Farbu (2022)
Cold stores workers (<−20°C) compared to normal Men RR 4.11 (2.66–6.34) Not reported 100 200 6 Ghani et al. (2020)
Upper back Working in 2°C compared to 8–12°C Men PR 2.24 (0.32–15.45) 2.5 50 112 9 Piedrahí;ta et al. (2004)
Cold stores workers (<−20°C) compared to normal Men RR 21.00 (6.82–64.65) Not reported 100 200 6 Ghani et al. (2020)
Neck North Men OR 1.57 (1.47–1.67) 8.6 23 514 118 258 10 Burstrom et al. (2013)
Central OR 1.18 (1.12–1.25) 57 148
Working in 2°C compared to 8–12°C Men PR 11.2 (1.34–93.4) 3.7 50 112 9 Piedrahí;ta et al. (2004)
Self-reported working in cold environments ≥25% of the time Both genders OR 1.46 (1.13–1.89) 13.7 779 6,553 8 Farbu et al. (2019)
Self-reported occupational exposure. Lowest tertile as reference Both genders OR 1.15 (0.99–1.34) 17.5 2093 8,740 Stjernbrandt and Farbu (2022)
Medium (2. tertile) OR 1.36 (1.16–1.59) 1958
High (3. tertile)
Self-reported leisure-time exposure. Categorized into tertiles. Lowest as reference Both genders OR 1.10 (0.95–1.28) Not reported Not reported 12 627 7 Stjernbrandt and Farbu (2022)
Cold stores workers (<−20°C) compared to normal Men RR 15.00 (6.33–35.51) Not reported 100 200 6 Ghani et al. (2020)
Neck/shoulder Experience of cooling at work Both genders OR 2.28 (1.48–3.50) 84 202 1,117 9 Sormunen et al. (2009)
Slight OR 3.88 (2.49–6.05) 283
Some OR 10.33 (4.81–22.19) 163
Extensive
Head/neck Per 10 h/week cold exposure Men OR 1.12 (0.98–1.26) 10 n.a 2,293 8 Raatikka et al. (2007)
Women OR 1.09 (0.86–1.37) 10.8 2,821
Shoulder Experience of cooling at work Both genders OR 2.77 (1.99–3.85) 65 177 1,117 9 Sormunen et al. (2009)
Slight OR 6.05 (4.03–9.10) 161
Some OR 11.28 (4.69–27.15) 45
Extensive
Working in 2°C compared to 8–12°C Men PR 4.48 (0.85–23.6) 3.7 50 112 9 Piedrahí;ta et al. (2004)
Per 10 h/week cold exposure Men OR 1.31 (1.12–1.51) 4.9 n.a 2,288 8 Raatikka et al. (2007)
Women OR 1.16 (0.81–1.98) 4.7 2,812
Self-reported cold exposure >4 h/day Men Not reported 28.0 149 2,161 8 Bodin et al. (2012)
Women OR 2.2 (1.3–3.8) 31.1 71 1,548
Occupational exposure Men RR 1.8 (0.6–5.4) 1 29 113 8 Pope et al. (1997)
Occasional RR 6.4 (1.5–27) 4.2 4
Always
Occasional Women RR 1.4 (0.4–5.1) 18.7 14 123
Always RR 1.1 (0.2–8−5) 5
Self-reported working in cold environments ≥25% of the time Both genders OR 1.39 (1.08–1.78) 13.7 779 6,553 8 Farbu et al. (2019)
Cold stores workers (<−20°C) compared to normal Men RR 151.00 (9.48–2,403.28) Not reported 100 200 6 Ghani et al. (2020)
Elbows 2°C compared to 8–12°C Men PR 2.24 (0.14–35.1) 1.2 50 112 9 Piedrahí;ta et al. (2004)
Elbows/forearms Per 10 h/week cold exposure Men Women OR 1.15 (0.94–1.45) 2.1 n.a 2,269 8 Raatikka et al. (2007)
OR 1.30 (0.79–1.98) 2.1 2,800
Arm Self-reported working in cold environments ≥25% of the time Both genders OR 1.34 (0.98–1.83) 8.4 779 6,553 8 Farbu et al. (2019)
Elbows Cold stores workers (<−20°C) compared to normal Men RR 10.40 (4.33–2,434.82) Not reported 100 200 6 Ghani et al. (2020)
Wrist Experience of cooling at work Both genders OR 2.74 (1.78−4–22) 70 54 1,117 9 Sormunen et al. (2009)
Slight OR 6.11 (4.01–9.31) 72 90
Some OR 20.12 (11.29–35.85)
Extensive
Wrists/hands 2°C compared to 8–12°C Men PR 2.24 (0.58–8.6) 4.9 50 112 9 Piedrahí;ta et al. (2004)
Wrists/palm Per 10 h/week cold exposure Men Women OR 1.11 (0.94–1.34) 5.6 n.a 2,268 8 Raatikka et al. (2007)
OR 1.51 (1.18–1.91) 6.9 2,795
Hand Self-reported working in cold environments ≥25% of the time Both genders OR 1.16 (0.79–1.71) 6 779 6,553 8 Farbu et al. (2019)
Fingers Per 10 h/week cold exposure Men Women OR 1.11 (0.95-1–27) 18.4 n.a 2,309 8 Raatikka et al. (2007)
OR 1.34 (1.11–1.60) 16.6 2,815
Wrists/hands Cold stores workers (<−20°C) compared to normal Men RR 23.33 (7.59–71.64) Not reported 100 200 6 Ghani et al. (2020)
Knees 2°C compared to 8–12°C Men PR 1.49 (0.26–8.66) 3.1 50 112 9 Piedrahí;ta et al. (2004)
Hip Self-reported working in cold environments ≥25% of the time Both genders OR 1.26 (0.90–1.75) 8.9 779 6,553 8 Farbu et al. (2019)
Knees/thighs/calves Per 10 h/week cold exposure Men Women OR 1.06 (0.90–1.23) 6.8 n.a 2,268 8 Raatikka et al. (2007)
OR 1.13 (0.85–1.46) 7.6 2,793
Leg Self-reported working in cold environments ≥25% of the time Both genders OR 1.47 (1.10–1.96) 10 779 6,553 8 Farbu et al. (2019)
Hips/thighs Cold stores workers (<−20°C) compared to normal Men RR 111.00 (6.95–1772.51) Not reported 100 200 6 Ghani et al. (2020)
Knees Cold stores workers (<−20°C) compared to normal Men RR 6.87 (3.45–13.67) Not reported 100 200 6 Ghani et al. (2020)
Ankles/feet 2°C compared to 8–12°C Men PR 2.24 (0.14–35.1) 1.2 50 112 9 Piedrahí;ta et al. (2004)
Per 10 h/week cold exposure Men Women OR 1.16 (1.03–1.30) 11 n.a 2,278 8 Raatikka et al. (2007)
OR 1.34 (1.08–1.64) 11.6 2,808
Foot Self-reported working in cold environments ≥25% of the time Both genders OR 0.8 (0.54–2.04) 6.6 779 6,553 8 Farbu et al. (2019)
Ankles/feet Cold stores workers (−20°C to −30°C) compared to normal Men RR 3.53 (2.13–5.83) Not reported 100 200 6 Ghani et al. (2020)

PR, Prevalence ratio; RR, Relative risk; OR, Odds ratio; IRR, Incidence rate ratio; CI, Confidence interval aCalculated by the authors of this review.