Tohr Nilsson | Umeå University (original) (raw)

Papers by Tohr Nilsson

Frontiers in Physiology

Background: Musculoskeletal conditions are major contributors to years lived with disability. Col... more Background: Musculoskeletal conditions are major contributors to years lived with disability. Cold exposure can be a risk factor, but any conclusion is obscure.Aim: The aim of the present scoping review was to identify the existing evidence of an association between cold exposure and musculoskeletal conditions. The aim also included to consider pain in different regions and their assessment, as well as different measures of cold exposure, effect sizes, and to assess the feasibility of future systematic reviews and meta-analyses.Eligibility criteria: The studies must have: an epidemiological design, defined cold exposure to come prior to the health outcome, defined exposure and outcome(s), existence of effect estimate(s) or data that made it possible to calculate such an estimate. Further, studies were required to be in English language and published in peer-reviewed journals. Studies that had a specific goal of studying cold exposure as an aggravator of already existing health probl...

Journal of Autoimmunity, 2014

Vasoconstriction accompanied by changes in skin color is a normal physiologic response to cold. T... more Vasoconstriction accompanied by changes in skin color is a normal physiologic response to cold. The distinction between this normal physiology and Raynaud's phenomenon (RP) has yet to be well characterized. In anticipation of the 9 th International Congress on Autoimmunity, a panel of 12 RP experts from 9 different institutes and four different countries were assembled for a Delphi exercise to establish new diagnostic criteria for RP. Relevant investigators with highly cited manuscripts in Raynaud's-related research were identified using the Web of Science and invited to participate. Surveys at each stage were administered to participants via the on-line SurveyMonkey software tool. The participants evaluated the level of appropriateness of statements using a scale of 1 (extremely inappropriate) through 9 (extremely appropriate). In the second stage, panel participants were asked to rank rewritten items from the first round that were scored as "uncertain" for the diagnosis of RP, items with significant disagreement (Disagreement Index > 1), and new items suggested by the panel. Results were analyzed using the Interpercentile Range Adjusted for Symmetry (IPRAS) method. A 3-Step Approach to diagnose RP was then developed using items the panelists "agreed" were "appropriate" diagnostic criteria. In the final stage, the panel was presented with the newly developed diagnostic criteria and asked to rate them against previous models. Following the first two iterations of the Delphi exercise, the panel of 12 experts agreed that 36 of the items were "appropriate," 12 items had "uncertain" appropriateness, and 13 items were "inappropriate" to use in the diagnostic criteria of RP. Using an expert committee, we developed a 3-Step Approach for the diagnosis of RP and 5 additional criteria for the diagnosis of primary RP. The committee came to an agreement that the proposed criteria were "appropriate and accurate" for use by physicians to diagnose patients with RP.

6th International Conference on Whole Body Vibration (WBV2017), 2017

Proceedings of the 7th American Conference on Human Vibration, 2018

I. i n t r o d u c t i o n Tingling, pricking or numbness in the hands (paresthesias) are associa... more I. i n t r o d u c t i o n Tingling, pricking or numbness in the hands (paresthesias) are associated with intensive hand use, age, and use of vibratory tools. The Hand-Arm Vibration International Consortium study provides longitudinal data on symptoms, and on some electrophysiological and psychophysical measurements, in four vibration exposed cohorts: shipyard workers, automotive assembly workers, forest workers, and dental hygienists. A raised prevalence of entrapment neuropathy, particularly carpal tunnel syndrome, was associated with age. However, intensive hand use and vibratory exposure predicted hand paresthesias in younger age groups. In industrial settings, where ergonomics and anti-vibration measures were optimized, the prevalence of hand paresthesias and of carpal tunnel syndrome were low. Hand paresthesias are common in certain occupational groups with vibration exposures. There are complex interactions between physiologic age, duration of exposure, and intensity of expos...

The Annals of occupational hygiene, 2009

This study clarifies whether the established frequency weighting procedure for evaluating exposur... more This study clarifies whether the established frequency weighting procedure for evaluating exposure to hand-transmitted vibration can effectively evaluate the temporary changes in vibrotactile perception thresholds due to pre-exposure to vibration. In addition, this study investigates the relationship between changes of the vibrotactile perception thresholds and the normalized energy-equivalent frequency-weighted acceleration. The fingers of 10 healthy subjects, five male and five female, were exposed to vibration under 16 conditions with a combination of different frequencies, intensities, and exposure times. The vibration frequencies were 31.5 and 125 Hz and exposure lasted between 2 and 16 min. According to International Organization for Standardization (ISO) 5349-1, the energy-equivalent frequency-weighted acceleration for the experimental time of 16 min is 2.5 or 5.0 m s(-2) root-mean-square, corresponding to a 8-h equivalent acceleration, A(8), of approximately 0.5 and 0.9 m s(...

Journal of Sound and Vibration, 2002

The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeleta... more The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeletal symptoms in the region of the neck, shoulders and upper and lower back for professional drivers of various categories of all-terrain vehicles and to assess the association between symptoms and duration of exposure to whole-body vibration (WBV) and shock from driving all-terrain vehicles. The study group consisted of 215 drivers of forest machines, 137 drivers of snowmobiles and 79 drivers of snowgroomers and a control group of 167 men randomly selected from the general population. The subjects were all from one of the four most northern counties in Sweden and they were all men. Musculoskeletal symptoms were assessed by use of a standardized questionnaire. In addition, the questionnaire held items about the driving time with all-terrain vehicles and a subjective estimation of exposure to unpleasant movements (shock, jolt, irregular sway). The job strain was measured according to Karasek's demands/control model. The prevalence ratios were adjusted for age, smoking and job strain. Among drivers, signi"cantly increased prevalence ratios within the range of 1)5}2)9 were revealed for symptoms from the neck}shoulder and thoracic regions during the previous year. None of the driver categories had a statistically signi"cantly increased risk of low back pain. Forest vehicles were those most reported to cause unpleasant movements. In conclusion, drivers of all-terrain vehicles exhibit an increased risk of symptoms of musculoskeletal disorders in the neck}shoulder and thoracic regions. The increased risk is suggested to be related to physical factors such as exposure to whole-body vibration (WBV) and shock, static overload or extreme body postures. However, since symptoms of low back pain were not signi"cantly increased, it appears that factors other than WBV would explain the occurrence of symptoms in the group of all-terrain drivers.

European Respiratory Journal, 2004

The aim of this study was to find out if occupational exposure to dust, fumes or gases, especiall... more The aim of this study was to find out if occupational exposure to dust, fumes or gases, especially among never-smokers, increased the mortality from chronic obstructive pulmonary disease (COPD). A cohort of 317,629 Swedish male construction workers was followed from 1971 to 1999. Exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), gases and irritants (epoxy resins, isocyanates and organic solvents), fumes (asphalt fumes, diesel exhaust and metal fumes), and wood dust was based on a job-exposure matrix. An internal control group with "unexposed" construction workers was used, and the analyses were adjusted for age and smoking. When all subjects were analysed, there was an increased mortality from COPD among those with any airborne exposure (relative risk 1.12 (95% confidence interval (CI) 1.03-1.22)). In a Poisson regression model, including smoking, age and the major exposure groups, exposure to inorganic dust was associated with an increased risk (hazard ratio (HR) 1.10 (95% CI 1.06-1.14)), especially among never-smokers (HR 2.30 (95% CI 1.07-4.96)). The fraction of COPD among the exposed attributable to any airborne exposure was estimated as 10.7% overall and 52.6% among never-smokers. In conclusion, occupational exposure among construction workers increases mortality due to chronic obstructive pulmonary disease, even among never-smokers.

Ergonomics, 2009

The purpose of this study was to investigate the existence of neck pain and arm pain among profes... more The purpose of this study was to investigate the existence of neck pain and arm pain among professional forest machine drivers and to find out if pain were related to their whole-body vibration (WBV) exposure. A self-administered questionnaire was sent to 529 forest machine drivers in northern Sweden and the response was 63%. Two pain groups were formed; 1) neck pain; 2) neck pain combined with arm pain. From WBV exposure data (recent measurements made according to ISO 2631-1, available information from reports) and from the self-administered questionnaire, 14 various WBV exposure/dose measures were calculated for each driver. The prevalence of neck pain reported both for the previous 12 months and for the previous 7 d was 34% and more than half of them reported neck pain combined with pain in one or both arms. Analysis showed no significant association between neck pain and high WBV exposure; however, cases with neck pain more often experienced shocks and jolts in the vehicle as uncomfortable. There was no significant association between the 14 WBV measures and type of neck pain (neck pain vs. neck pain combined with arm pain). It seems as if characteristics of WBV exposure can explain neither existence nor the type of neck pain amongst professional drivers of forest machines. The logging industry is important for several industrialised countries. Drivers of forest machines frequently report neuromusculoskeletal pain from the neck. The type of neck pain is important for the decision of treatment modality and may be associated with exposure characteristics at work.

Proceedings of the Third American Conference on Human Vibration, June 1-4, 2010, 2016

International Journal of Circumpolar Health, 2016

Halsoundersokning bland arbetande inom gruvnaring i Barentsregionen : Deskriptiva data fran basen... more Halsoundersokning bland arbetande inom gruvnaring i Barentsregionen : Deskriptiva data fran basenkaten, Aitik Boliden november 2012