{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T22:01:08Z","timestamp":1771192868225,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre for Research Expertise in Occupational Disease"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous research on functional impairments due to vascular effects in workers with hand-arm vibration syndrome (HAVS) has focused on the upper extremities with little attention to the lower extremities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the severity and factors associated with cold intolerance and sensitivity in the hands and feet of workers with HAVS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey and retrospective chart review were used to collect demographics, work conditions and disease characteristics on workers undergoing HAVS assessments. Data also included workers\u2019 scores on the Cold Intolerance Symptom Severity (CISS) questionnaire, which was adapted to evaluate the upper and lower extremities separately. Associations between upper and lower extremity scores were explored using Spearman correlations and Wilcoxon signed rank tests, and regression models were used to evaluate whether variables of interest predicted CISS total scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (N\u2009=\u200993; 55% response rate) worked primarily in mining and construction, were exclusively male, and had a mean age of 48\u2009years. Cold intolerance and sensitivity were commonly reported in the feet and correlated with hand symptoms, but most CISS individual questions and total scores were significantly higher for the hands (versus feet). Regression models indicated that QuickDASH and Stockholm vascular scale scores significantly predicted CISS total scores for the hands, while exposure to foot vibration, plethysmography severity scores of the feet and QuickDASH scores significantly predicted CISS total scores for the feet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicians should assess and treat cold intolerance and sensitivity in both the hands and feet of workers with HAVS to improve workers\u2019 daily functioning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/occmed\/kqaf115","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T13:00:25Z","timestamp":1766581225000},"page":"13-20","source":"Crossref","is-referenced-by-count":0,"title":["Exploring cold sensitivity among workers with hand-arm vibration syndrome"],"prefix":"10.1093","volume":"76","author":[{"given":"S","family":"Bezanson","sequence":"first","affiliation":[{"name":"Interdisciplinary Health Program, St. Francis Xavier University , Antigonish, Nova Scotia, B2G 2W5,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0221-5836","authenticated-orcid":false,"given":"A","family":"Ruco","sequence":"additional","affiliation":[{"name":"Interdisciplinary Health Program, St. Francis Xavier University , Antigonish, Nova Scotia, B2G 2W5,","place":["Canada"]},{"name":"Peter Gilgan Centre for Women\u2019s Cancers, Women\u2019s College Hospital , Toronto, Ontario, M5S 1B2,","place":["Canada"]},{"name":"VHA Home HealthCare , Toronto, Ontario, M4S 1V6,","place":["Canada"]},{"name":"Nova Scotia Health , Halifax, Nova Scotia, B3H 1V8,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Howse","sequence":"additional","affiliation":[{"name":"Interdisciplinary Health Program, St. Francis Xavier University , Antigonish, Nova Scotia, B2G 2W5,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Budd","sequence":"additional","affiliation":[{"name":"Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Unity Health Toronto , Toronto, Ontario, M5B 1X3,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"House","sequence":"additional","affiliation":[{"name":"Division of Occupational Medicine, Department of Medicine, St. Michael\u2019s Hospital, Unity Health Toronto , Toronto, Ontario, M5B 1W8,","place":["Canada"]},{"name":"Dalla Lana School of Public Health and Department of Medicine, University of Toronto , Toronto, Ontario, M5T 3M7,","place":["Canada"]},{"name":"Division of Occupational Medicine, Department of Medicine, University of Toronto , Toronto, Ontario, M5S 3K3,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Khakpour","sequence":"additional","affiliation":[{"name":"Interdisciplinary Health Program, St. Francis Xavier University , Antigonish, Nova Scotia, B2G 2W5,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6632-7688","authenticated-orcid":false,"given":"D L","family":"Holness","sequence":"additional","affiliation":[{"name":"Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Unity Health Toronto , Toronto, Ontario, M5B 1X3,","place":["Canada"]},{"name":"Division of Occupational Medicine, Department of Medicine, St. Michael\u2019s Hospital, Unity Health Toronto , Toronto, Ontario, M5B 1W8,","place":["Canada"]},{"name":"Dalla Lana School of Public Health and Department of Medicine, University of Toronto , Toronto, Ontario, M5T 3M7,","place":["Canada"]},{"name":"Division of Occupational Medicine, Department of Medicine, University of Toronto , Toronto, Ontario, M5S 3K3,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2026021516164407500_kqaf115-B1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1080\/15459624.2023.2197634","article-title":"Exposure to hand-arm vibrations in the workplace and the occurrence of hand-arm vibration syndrome, Dupuytren\u2019s contracture, and hypothenar hammer syndrome: a systematic review and meta-analysis","volume":"20","author":"Gerger","year":"2023","journal-title":"J Occup Environ Hyg"},{"key":"2026021516164407500_kqaf115-B2","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1177\/1753193410396636","article-title":"Hand-arm vibration syndrome: a common 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