Diabetes is a serious risk factor for nerve injury. About half of diabetics develop nerve damage (“peripheral neuropathy”) due to their diabetes,10 and pre-existing/chronic nerve damage is an important predisposing factor for acute nerve damage.11 12 Very thin people are at higher risk for acute compression nerve injury.11Other conditions that can make people more prone to nerve damage include alcoholism, poor nutrition or vitamin deficiency (especially vitamins B6 and B12), thyroid disease, kidney disease, and autoimmune diseases like lupus or MS.14 "Systemic conditions such as obesity, diabetes, rheumatoid arthritis and other neuropathies will similarly render a given individual more susceptible to the development of... compressions."27 Existing subclinical (asymptomatic) nerve injury is a risk factor to develop a symptomatic nerve injury.11 Studies of baseball players have shown that cumulative microtrauma from repetitive overuse places them a risk for peripheral nerve injury of the upper extremities.13 "A proximal level of nerve compression could cause more distal sites to be susceptible to compression."30 In a bondage context, there is anecdotal evidence that bondage injuries are cumulative. This means that perhaps a bottom who has been put in a box tie the exact same way 50 times and never had symptoms of nerve damage might the 51st time suffer from a symptomatic nerve injury, even though there was nothing special, different, or “wrong” that 51st time. A cold environment may be a risk factor for nerve damage. Interaoperative nerve damage is very similar to bondage nerve damage in many ways – it is generally compression/position related. A relevant study found that, all other things being equal, patients who are cooled during surgery have more incidence of intraoperative nerve damage than those who are NOT cooled.3 So it's likely risky to do suspensions in an icebox, and if the bottom warms up prior to the scene, this may help prevent injury.