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The current study also aimed to explore whether thermal comfort affected health and performance outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A questionnaire was used to collect data from three different professions: preschool (n = 65), park and maintenance (n = 36), and power grid workers (n = 31). The questionnaire contained items related to background variables (sex, age, body mass index, tobacco use, pre-existing diseases, and clothes provided by the employer), thermal comfort, self-assessed health, and performance outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings show that women, to a greater extent than men, experience cold-related discomfort while working in cold environments. Cold sensitivity was most common among park and maintenance workers (57%) and power grid workers (47%). Raynaud\u2019s phenomenon and abnormal cold sensitivity were most common among park and maintenance workers, with a prevalence of 31% and 56%, respectively. Statistically significant differences were also found in all reported performance outcomes (concentration, endurance, mobility, strength, and speed) between the different professions. Associations between cold-related discomfort and an increased reporting of health symptoms and a decrease in performance outcomes were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There were differences in perceived thermal comfort, health, and performance outcomes between different outdoor professions and sexes. The associations between cold-related discomfort, cold-related symptoms, and decreased performance indicate a need to implement cold risk management to ensure a safe work environment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annweh\/wxag025","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:54:11Z","timestamp":1775044451000},"source":"Crossref","is-referenced-by-count":0,"title":["Thermal comfort, health, and performance effects among outdoor workers in northern Sweden"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8193-1352","authenticated-orcid":false,"given":"Rebecca","family":"Tapper","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Global Health, Ume\u00e5 University , Ume\u00e5 901 87 ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edit","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Department of 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