Exposure to cold weather is something we will all encounter during the winter. The risk of cold‐related injuries and illnesses certainly is greater with lower temperatures, but even prolonged exposures to cool conditions with high winds and/or precipitation can lead to problems. It’s important that we recognize cold‐related injuries and illnesses and know how to prevent and treat them.

Hypothermia

Hypothermia is when the body loses heat faster than it can be replaced and is a potentially serious condition. When the core body temperature drops to approximately 95°F, the onset of symptoms normally begins. The employee may shiver, lose coordination, have slurred speech, fumble with items in their hands and their skin will likely be pale and cold.

As the body temperature continues to fall, these symptoms will worsen and shivering will stop. Once the body temperature falls to around 85°F, severe hypothermia will develop and the person may become unconscious, and at 78°F, vital organs may begin to fail.

Treatment depends on the severity of the hypothermia. For cases of mild hypothermia, move to warm area and stay active. Remove wet clothes and replace with dry clothes or blankets, cover the head. To promote metabolism and assist in raising internal core temperature, drink a warm (not hot) sugary drink. Avoid drinks with caffeine.

For more severe cases do all the above, plus contact emergency medical personnel (Call 911 for an ambulance), cover all extremities completely, place very warm objects, such as hot packs or water bottles on the victim’s head, neck, chest and groin. Arms and legs should be warmed last. In cases of severe hypothermia, treat the employee very gently and do not apply external heat to re‐warm.

Frostbite

Frostbite occurs when the skin freezes and loses water. Amputation of the frostbitten area may occur in severe cases. Frostbite normally occurs when temperatures are 30°F or below. During windy conditions the wind chill may allow frostbite to occur at higher temperatures.

Frostbite typically affects the extremities, particularly the feet and hands. The affected body part will be cold, tingling, stinging or aching followed by numbness. Skin color turns red, then purple, then white, and is cold to the touch and there may be blisters in severe cases.

Do not rub the area to warm it. Wrap the area in a soft cloth, move the employee to a warm area, and contact medical personnel. Do not leave the employee alone. If help is delayed, immerse in warm (maximum 105 °F), not hot, water. Do not pour water directly on affected part. If there is a chance that the affected part will get cold again do not warm. Repeated heating and cooling of the skin may cause severe tissue damage.

Trench Foot

Trench Foot is caused by having feet exposed to damp, unsanitary and cold conditions at temperatures above freezing for long periods of time. It is similar to frostbite, but considered less severe.

Symptoms usually consist of tingling, itching or burning sensation. Blisters may be present.

For treatment, soak feet in warm water, then wrap with dry cloth bandages. Drink a warm, sugary drink. Seek medical attention if necessary.

Chilblains

Chilblains are the painful inflammation of small blood vessels in the skin that occur in response to sudden warming from cold temperatures. Also known as pernio, chilblains can cause itching, red patches, swelling and blistering on extremities, such as on your toes, fingers, ears and nose.

Signs and symptoms of chilblains may include small, itchy red areas on your skin, often on your feet or hands, possible blistering, swelling of your skin, burning sensation on your skin, changes in skin color from red to dark blue, accompanied by pain and possible ulceration.

For treatment keep the affected area warm and avoid any extreme temperature changes. Seek medical advice if blistering, numbness or skin ulceration occurs.

Prevention

The best way to prevent cold‐related injuries and illness is to minimize exposure time to cold conditions by scheduling work for warmer time periods, using extra employees and taking breaks in heated locations when feasible.

Wear several layers of clothing including a water resistant outer layer. Always wear a hat to prevent heat loss through the head. Wear insulated boots and keep all exposed skin covered in conditions with very low temperatures and/or high winds. Stay well hydrated with warm beverages and take frequent snack breaks since your body will require more calories in cold conditions to maintain a proper core temperature.

If you see any symptoms of hypothermia, frost bite, trench foot or chilblains leave the cold area immediately for a warmer location and begin treatment.