Introduction
Raynaud’s phenomenon
Cold sensitivity
Objective
Methods
Study design
Setting
Participants
Variables
Statistical methods
Results
Participants
Study population characteristics (Table 1)
RP cases with CS | RP cases without CS | Controls | ||||
---|---|---|---|---|---|---|
N
| % |
N
| % |
N
| % | |
Responders | 228 | 233 | 763 | |||
Sex | ||||||
Men | 90 | 39.5 | 90 | 38.6 | 308 | 40.4 |
Women | 138 | 60.5 | 143 | 61.4 | 455 | 59.6 |
Age group | ||||||
18–29 | 16 | 7.0 | 7 | 3.0 | 32 | 4.2 |
30–39 | 16 | 7.0 | 15 | 6.4 | 50 | 6.6 |
40–49 | 52 | 22.8 | 41 | 17.6 | 147 | 19.3 |
50–59 | 70 | 30.7 | 64 | 27.5 | 212 | 27.8 |
60–70 | 74 | 32.5 | 106 | 45.5 | 322 | 42.2 |
Geographical region | ||||||
Alpine | 51 | 22.4 | 51 | 21.9 | 165 | 21.6 |
Inland | 67 | 29.4 | 54 | 23.2 | 206 | 27.0 |
Coastal | 110 | 48.2 | 128 | 54.9 | 392 | 51.4 |
Cold sensitivity measures | ||||||
CISS > 50 | 96 | 50.3 | 4 | 2.1 | 33 | 5.9 |
CISS ≤ 50 | 95 | 49.7 | 185 | 97.9 | 526 | 94.1 |
VAS > 50 | 211 | 95.5 | 91 | 41.6 | 166 | 22.7 |
VAS ≤ 50 | 10 | 4.5 | 128 | 58.4 | 566 | 77.3 |
Occupation | ||||||
Managers | 6 | 2.8 | 11 | 4.8 | 27 | 3.6 |
Professionals | 46 | 21.1 | 44 | 19.4 | 115 | 15.4 |
Technicians and associate professionals | 21 | 9.6 | 31 | 13.7 | 75 | 10.1 |
Clerical support workers | 22 | 10.1 | 20 | 8.8 | 68 | 9.1 |
Service and sales workers | 29 | 13.3 | 23 | 10.1 | 115 | 15.4 |
Skilled agricultural, forestry, and fishery workers | 3 | 1.4 | 3 | 1.3 | 13 | 1.7 |
Crafts and related trades workers | 10 | 4.6 | 11 | 4.8 | 26 | 3.5 |
Plant and machine operators and assemblers | 19 | 8.7 | 11 | 4.8 | 43 | 5.8 |
Elementary occupations | 2 | 0.9 | 4 | 1.8 | 15 | 2.0 |
Armed forces occupations | 2 | 0.9 | 0 | 0.0 | 2 | 0.3 |
Self-employed | 5 | 2.3 | 5 | 2.2 | 14 | 1.9 |
Students | 5 | 2.3 | 4 | 1.8 | 11 | 1.5 |
Unemployed | 2 | 0.9 | 2 | 0.9 | 15 | 2.0 |
Parental leave | 0 | 0.0 | 0 | 0.0 | 2 | 0.3 |
Sick leave | 5 | 2.3 | 2 | 0.9 | 13 | 1.7 |
Retired | 41 | 18.8 | 56 | 24.7 | 192 | 25.7 |
Univariate analyses (Tables 2, 3)
Factor | Exposure level | RP cases with CS (N = 228) | Controls (N = 379) | RP cases without CS (N = 233) | Controls (N = 384) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N
| % | OR | 95% CI |
N
| % |
N
| % | OR | 95% CI |
N
| % | ||
BMI | BMI < 18.5 | 2 | 0.9 | 0.99 | 0.16–6.02 | 3 | 0.8 | 1 | 0.4 | 0.35 | 0.03–3.59 | 3 | 0.8 |
18.5 ≤ BMI < 25 | 144 | 64.0 | 1 | – | 155 | 41.8 | 125 | 54.8 | 1 | – | 143 | 38.4 | |
BMI ≥ 25 | 79 | 35.1 | 0.37* |
0.25–0.54
| 213 | 57.4 | 102 | 44.7 | 0.50* |
0.35–0.71
| 226 | 60.8 | |
Heredity | |||||||||||||
Raynaud’s phenomenona | Yes | 75 | 33.8 | 3.90* |
2.49–6.11
| 41 | 11.2 | 83 | 37.4 | 5.03* |
3.11–8.15
| 41 | 11.1 |
No | 147 | 66.2 | 1 | – | 324 | 88.8 | 139 | 62.6 | 1 | – | 329 | 88.9 | |
Tobacco use | |||||||||||||
Daily tobacco use | Yes | 52 | 22.8 | 1.40 | 0.93–2.11 | 66 | 17.5 | 59 | 25.5 | 1.45 | 0.97–2.17 | 81 | 21.6 |
No | 176 | 77.2 | 1 | – | 311 | 82.5 | 172 | 74.5 | 1 | – | 294 | 78.4 | |
Therapeutic drug use | |||||||||||||
Affecting peripheral nervesb | Yes | 23 | 12.6 | 0.92 | 0.46–1.84 | 37 | 13.9 | 24 | 14.3 | 0.72 | 0.41–1.27 | 56 | 19.9 |
No | 160 | 87.4 | 1 | – | 230 | 86.1 | 144 | 85.7 | 1 | – | 226 | 80.1 | |
Affecting peripheral circulationc | Yes | 41 | 22.9 | 1.53 | 0.88–2.67 | 54 | 20.8 | 30 | 18.2 | 1.23 | 0.69–2.22 | 48 | 17.1 |
No | 138 | 77.1 | 1 | – | 206 | 79.2 | 135 | 81.8 | 1 | – | 232 | 82.9 | |
Diseases and injuries | |||||||||||||
Vascular diseased | Yes | 27 | 12.9 | 1.79* |
1.01–3.19
| 28 | 7.7 | 26 | 11.4 | 1.49 | 0.81–2.74 | 31 | 8.5 |
No | 183 | 87.1 | 1 | – | 336 | 92.3 | 202 | 88.6 | 1 | – | 334 | 91.5 | |
Diabetes mellitus | Yes | 8 | 3.6 | 0.77 | 0.33–1.78 | 19 | 5.1 | 6 | 2.6 | 0.48 | 0.19–1.24 | 22 | 5.8 |
No | 217 | 96.4 | 1 | – | 354 | 94.9 | 225 | 97.4 | 1 | – | 355 | 94.2 | |
Migraines | Yes | 32 | 14.3 | 1.96* |
1.14–3.36
| 30 | 8.1 | 16 | 7.0 | 0.67 | 0.37–1.21 | 39 | 10.4 |
No | 192 | 85.7 | 1 | – | 341 | 91.9 | 211 | 93.0 | 1 | – | 335 | 89.6 | |
Rheumatic diseasee | Yes | 15 | 7.1 | 2.05 | 0.99–4.25 | 14 | 3.8 | 6 | 2.6 | 1.08 | 0.51–2.29 | 10 | 2.7 |
No | 196 | 92.9 | 1 | – | 351 | 96.2 | 216 | 97.3 | 1 | – | 362 | 97.3 | |
Carpal tunnel syndrome | Yes | 22 | 10.0 | 1.24 | 0.67–2.30 | 31 | 8.4 | 20 | 8.7 | 1.40 | 0.74–2.64 | 26 | 6.9 |
No | 198 | 90.0 | 1 | – | 339 | 91.6 | 209 | 91.3 | 1 | – | 350 | 93.1 | |
Polyneuropathy | Yes | 7 | 3.2 | 5.58* |
1.12–27.79
| 3 | 0.8 | 0 | 0 | 0.03 | 0.00–18.71 | 7 | 1.8 |
No | 215 | 96.8 | 1 | – | 362 | 99.2 | 225 | 100.0 | 1 | – | 374 | 98.2 | |
Upper extremity nerve injury | Yes | 73 | 32.7 | 2.09* |
1.42–3.09
| 72 | 19.4 | 46 | 20.4 | 1.17 | 0.77–1.79 | 65 | 17.1 |
No | 150 | 67.3 | 1 | – | 300 | 80.6 | 180 | 79.6 | 1 | – | 316 | 82.9 | |
Frostbite handsf | Yes | 89 | 39.2 | 13.13* |
6.79–25.40
| 23 | 6.1 | 36 | 15.6 | 4.26* | 2.23–8.12* | 15 | 4.0 |
No | 138 | 60.8 | 1 | – | 354 | 93.9 | 195 | 84.4 | 1 | – | 364 | 96.0 |
Factor | Exposure level | RP cases with CS (N = 228) | Controls (N = 379) | RP cases without CS (N = 233) | Controls (N = 384) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N
| % | OR | 95% CI |
N
| % |
N
| % | OR | 95% CI |
N
| % | ||
Cold exposure measures | |||||||||||||
Occupational cold exposurea (NRS 1–10) | High (NRS > 1) | 110 | 50.7 | 1.44 | 0.995–2.09 | 144 | 40.1 | 84 | 37.7 | 1.15 | 0.78–1.71 | 131 | 36.1 |
Low (NRS 1) | 107 | 49.3 | 1 | – | 215 | 59.9 | 139 | 62.3 | 1 | – | 232 | 63.9 | |
Leisure-time cold exposureb (NRS 1–10) | High (NRS > 5) | 120 | 54.1 | 1.11 | 0.79–1.57 | 185 | 49.6 | 127 | 56.2 | 1.48* |
1.04–2.12
| 177 | 47.3 |
Low (NRS ≤ 5) | 102 | 45.9 | 1 | – | 188 | 50.4 | 99 | 43.8 | 1 | – | 197 | 52.7 | |
Cumulative cold exposurec (NRS 2–20) | High (NRS > 8) | 123 | 57.5 | 1.47* |
1.03–2.09
| 160 | 44.9 | 96 | 43.4 | 1.12 | 0.77–1.64 | 149 | 41.3 |
Low (NRS ≤ 8) | 91 | 42.5 | 1 | – | 196 | 55.1 | 125 | 56.6 | 1 | – | 212 | 58.7 | |
Handling cold objects during work | Yes | 74 | 33.3 | 3.06* |
1.92–4.90
| 61 | 16.4 | 45 | 19.7 | 1.09 | 0.70–1.72 | 70 | 18.5 |
No | 148 | 66.7 | 1 | – | 311 | 83.6 | 184 | 80.3 | 1 | – | 308 | 81.5 | |
Extreme cold, wind or cooling moisture during work | Yes | 81 | 36.2 | 2.41* |
1.53–3.79
| 88 | 23.7 | 55 | 23.9 | 0.94 | 0.62–1.43 | 93 | 24.6 |
No | 143 | 63.8 | 1 | – | 284 | 76.3 | 175 | 76.1 | 1 | – | 285 | 75.4 | |
Occupational HAV exposure measures | |||||||||||||
Impact tools | Yes | 39 | 17.4 | 2.60* |
1.49–4.54
| 28 | 7.5 | 30 | 13.1 | 1.49 | 0.86–2.58 | 34 | 9.0 |
No | 185 | 82.6 | 1 | – | 344 | 92.5 | 199 | 86.9 | 1 | – | 344 | 91.0 | |
Rapidly rotating tools | Yes | 7 | 3.2 | 2.00 | 0.62–6.41 | 5 | 1.3 | 8 | 3.5 | 1.13 | 0.43–3.02 | 10 | 2.7 |
No | 215 | 96.8 | 1 | – | 366 | 98.7 | 219 | 96.5 | 1 | – | 366 | 97.3 | |
Forestry/gardening tools | Yes | 35 | 15.8 | 1.40 | 0.80–2.45 | 50 | 13.5 | 33 | 14.7 | 1.18 | 0.69–2.04 | 48 | 12.7 |
No | 187 | 84.2 | 1 | – | 321 | 86.5 | 192 | 85.3 | 1 | – | 329 | 87.3 | |
Vibrating tools | Yes | 44 | 19.6 | 2.21* |
1.29–3.76
| 40 | 10.8 | 39 | 17.0 | 1.49 | 0.91–2.44 | 46 | 12.3 |
No | 180 | 80.4 | 1 | – | 330 | 89.2 | 190 | 83.0 | 1 | – | 329 | 87.7 | |
Heavily vibrating tools | Yes | 39 | 17.5 | 2.81* |
1.52–5.19
| 32 | 8.6 | 34 | 14.8 | 2.13* |
1.21–3.74
| 29 | 7.7 |
No | 184 | 82.5 | 1 | – | 338 | 91.4 | 196 | 85.2 | 1 | – | 348 | 92.3 | |
Vehicles with vibrating controls | Yes | 34 | 15.2 | 1.94* |
1.11–3.38
| 36 | 9.7 | 28 | 12.2 | 1.21 | 0.68–2.16 | 39 | 10.4 |
No | 189 | 84.8 | 1 | – | 336 | 90.3 | 201 | 87.8 | 1 | – | 335 | 89.6 | |
Any HAV exposured | Yes | 67 | 31.0 | 1.98* |
1.23–3.19
| 79 | 21.5 | 54 | 24.1 | 1.19 | 0.76–1.86 | 78 | 21.1 |
No | 149 | 69.0 | 1 | – | 289 | 78.5 | 170 | 75.9 | 1 | – | 291 | 78.9 |