Cold Stress Illness

Long exposure to cold, wet, and windy conditions can be dangerous even at temperatures above freezing. Since many agricultural and research tasks must be completed regardless of the weather conditions it is important to remember it takes longer to complete even simple tasks in the winter. Multiple layers of clothing, poor working / walking surface conditions or severe weather can all additional time to outdoor tasks. Even though it may be tempting to "tough it out" or "work through it," prolonged exposure to cold, wet, and windy conditions can be dangerous. Contributing factors of developing a cold stress condition are cold temperatures, high winds, dampness, and exposure to cold water.

Four specific conditions that can result from cold stress are:

Hypothermia: The body is unable to produce heat because it used all its stored energy. Early symptoms include shivering, fatigue and loss of coordination. Late symptoms include dilated pupils, slowed pulse and breathing or even loss of consciousness. First Aid should include:
Call 911
Seek a warm room or shelter
Remove any wet clothing
Warm the chest, neck, head, and groin first with an electric blanket
If able, give / consume warm beverages. Not alcohol or caffeine
Keep dry and wrapped in a warm blanket
Administer CPR if pulse is lost

Frostbite: The skin freezes and loses water. Symptoms include reduced blood flow to hands and feet, numbness / aching / tingling / stinging - especially to fingers and toes, bluish or pale, waxy skin. First Aid should include:
Seek a warm room ASAP
Avoid walking on frost bitten feet or toes
Soak affected area in warm (not hot) water
Do not use heating pad, fireplace, or radiator for warming
Rubbing the area may cause more tissue damage
Wrap in a soft cloth

Trench foot: Caused by prolonged exposure of the feet, to wet and cold conditions. It can occur if feet are constantly wet. It is similar to frost bite, but less severe. Symptoms include reddening of the skin, numbness, leg cramps, swelling, tingling pain, blisters/ulcers or bleeding under the skin. First Aid should include:
Remove shoes/boots and wet socks
Dry feet
Avoid walking on feet to avoid more tissue damage

Chilblains: Painful inflammation of small blood vessels in your skin that occur from repeated cold temperature exposure or a response to sudden warming of the skin, from cold temperatures.  Symptoms include redness, possible blistering, inflammation, and possible ulceration in severe cases. First Aid should include:
Do not scratch
Slowly warm the skin
Use corticosteroid creams to relieve itching and swelling
Keep blisters and ulcers clean and covered

Cold Stress Prevention

Clothing should be your first consideration when working in cold weather. Clothing
should be selected to suit the temperature, weather conditions (e.g., wind speed, rain),
and the level and duration of the activity.

Clothing recommendations for working in cold environments:
- Wear several layers of clothing. Trapped air between layers forms a protective insulation.
- Wear warm gloves, and keep an extra pair handy in case the first pair becomes wet.
- Wear a hat that provides protection for head, ears, and even face in extreme conditions. Forty percent of a person's body heat can be lost when the head is left exposed.
- Use the hoods of jackets or sweatshirts for added protection for your neck, head, face, and ears.
- Wear footwear appropriate for weather and work conditions. Footwear should not fit too tightly, which could reduce blood flow to the feet and increase the risk of a cold injury.
- Wear synthetic, wool, or silk clothing next to the skin to wick away moisture. Cotton clothing can lose insulating properties when it becomes damp or wet.

Additional safety precautions while working in cold weather:
- Avoid getting wet. Body heat is lost 24 times faster when clothing is wet.
- Take short, frequent breaks in areas sheltered from the elements, to allow the body to warm up.
- Avoid exhaustion and fatigue because energy is needed to keep muscles warm.
- Consume warm, high-calorie food to maintain energy reserves, such as pasta or hot cereal.
- Drink warm, sweet beverages to reduce the risk of dehydration, and avoid alcohol and caffeine.
- Work in pairs (buddy system), especially in remote areas, to keep an eye on each other and watch for signs of cold stress.
- Have a cell phone handy to call for help in the event of an emergency.
- Shield work areas from the elements to reduce wind chill or the chances of getting wet (windbreak, tent, or roof).
- Utilize insulating material on equipment handles, especially metal handles, when temperatures drop below 30°F.

Resources:
OSHA - Cold Weather Preparedness
Ohio BWC - Cold Stress Safety Talk
NOAA - Cold Weather Safety
NOAA - Wind Chill Chart & Calculator
NIOSH - Cold Stress Resources

Contacts:
If you have any questions regarding Cold Stress Illness, please contact Kent McGuire at mcguire.225@osu.edu or 292-0588. You may also contact the OSU Environmental Health and Safety Office online at http://ehs.osu.edu/OccHealthSafety/default.aspx or by phone at (614) 292-1284.

Reviewed / Updated: 1/13/23 K. McGuire