Cold temperature and low humidity were associated with increased occurrence of RTIs, and a decrease in temperature and humidity preceded the onset of the infections.

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Cold in- and outdoor work can result in different adverse effects on human health. Health problems decrease performance and work productivity and increase the occurrence of accidents and injuries. Serious health problems can also result in absence from work due to sick leave or hospitalization. At its worst, work in cold conditions could be associated with deaths due to cold-related accidents or a sudden health event. Musculoskeletal complaints, like pain, aches etc. are common in indoor cold work. Breathing cold air while working may lead to respiratory symptoms, which can decrease performance in cold. The symptoms are usually worsened by exercise and ageing, being more common in persons having a respiratory disease. Cardiovascular complaints and related performance decrements could be especially pronounced during work in cold weather and involving physical exercise, especially among those with an underlying cardiovascular disease. The article also reviews the current information related to diabetes, skin disorders and diseases, as well as cold injuries and accidents occurring in cold work. Increasing awareness and identifying workplace- and individual-related cold risks is the first step in proper cold risk management. Following this, the susceptible population groups need customized advice on proper prevention and protection in cold work.

The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide FINRISK 2002 health survey performed in Finland, 8,723 people aged 25-64 years filled in a questionnaire asking about the number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases, and degradation of performance. Cold thermal sensations at +5 degrees C to -5 degrees C were reported by 35% of men and 46% of women. Almost all subjects reported at least some cold-related complaints, most commonly musculoskeletal pain (men 30%, women 27%), followed by respiratory (25% / 29%), white finger (15% / 18%) and episodic peripheral circulation symptoms (12% / 15%). Decreased mental or physical performance in cold was reported by 75% of men and 70% of women, most commonly impairing manual dexterity and tactile sense. With declining temperature, the first symptom to emerge was pain in the elbow or the forearm (at -3 degrees C), followed by increased excretion of mucus from the lungs (-5 degrees C), while most other symptoms appeared only at lower temperatures of -15 degrees C to -20 degrees C. Most symptoms showed little or no association with the weekly duration of exposure, with the exception of cold-induced pain at most sites. Although, in general, Finns are well adapted to the cold climate, the high prevalence of cold-related complaints poses a challenge to the health care system in terms of decreased performance and the possibility that such symptoms predict more serious health effects, such as increased mortality.