In the winter, it’s important to take extra precautions to protect the health of employees who are exposed to cold temperatures.

Workers vulnerable to cold stress include those in construction, mining, logging, agriculture, fishing, recreation, transportation, oil and gas production, and utilities, and members of road crews and first responder teams. Jobs that involve frequent exposure to low indoor temperatures, such as refrigerated storage areas or research labs, also pose health risks.

Cold temperatures cause blood vessels and arteries to narrow, restricting blood flow and reducing the amount of oxygen pumped to the heart. When the heart has to work harder to circulate blood, blood pressure and heart rate increase, increasing the risk for heart attack and stroke.

A worker whose job involves physical exertion may not notice signs and symptoms of cold stress until the condition has advanced to a serious stage.

Types of Cold Stress

Several conditions fall into the category of cold stress. They include:

Frostnip and frostbite: When the skin’s surface and deeper tissues freeze, feeling and natural color are lost in affected areas. Symptoms of early-stage frostbite include numbness, tingling or stinging. Frostbite cause achiness and affected skin turns blue, pale and waxy. In advanced stages, tendons, muscles, nerves and bone are damaged and skin may turn black. Frostbite can lead to amputation.

If caught early, it is possible to recover from frostbite. Mildly frozen tissue may be rewarmed and insulated until medical attention is received as long as there is no danger of refreezing. If you suspect frostbite:

• Get indoors immediately.
• Seek medical attention.
• Remove constrictive clothing and jewelry that could impair circulation.
• Place dry, sterile gauze between toes and fingers to absorb moisture and keep them from sticking together.
• Elevate the affected area to reduce pain and swelling.
• For superficial frostbite, place the affected area in warm, not hot, water until the tissue softens.

Hypothermia: This occurs when an individual’s core temperature falls below 95°F and the body is not able to rewarm itself. Hypothermia can occur even when temperatures are relatively mild if a person gets wet or it’s windy. Initial symptoms include shivering, fatigue, loss of coordination and disorientation; late symptoms include ceasing of shivering, dilated pupils, slowed pulse and breathing, drowsiness and loss of consciousness.

When assisting a co-worker or companion with signs of hypothermia:

• Request immediate medical assistance.
• Move the person to a warm, dry room or shelter.
• Remove wet clothing, shoes and socks.
• Keep the person in a horizontal position and cover him or her with layers of blankets or towels and a vapor barrier (e.g., tarp, garbage bag). Cover the head and neck but not the face.
• If alert, offer a warm, sweetened, non-alcoholic beverage.
• Place warm bottles or hot packs in armpits, the groin area and along sides of the chest. Ask emergency technicians for additional rewarming instructions.

Chilblains: Small blood vessels in the skin become inflamed in response to repeated exposure to cold but non-freezing temperatures. Symptoms include redness, itching, blistering, inflammation and ulceration. If you have chilblains, consult with a medical professional and

• Avoid scratching.
• Slowly warm the skin.
• Use corticosteroid creams to relieve itching and swelling.
• Keep blisters and ulcers clean and covered.

Trench foot: After prolonged exposure to wet and cold-related conditions, the body constricts blood vessels in the feet to prevent heat loss, causing the skin tissue to die. Symptoms include reddening of the skin, numbness, leg cramps, swelling, tingling pain, blisters or ulcers, bleeding under the skin and gangrene.

For immediate care, avoid walking, remove footwear and socks, and dry the feet. Moving to a warm, dry area and using rewarming techniques is usually only minimally effective. Seek medical treatment.

Prevention

To help prevent cold stress, employees should be reminded to:

• Wear several layers of loosely fitted clothing to insulate the body and avoid tight clothing that reduces blood circulation or affects the range of motion.
• Wear gloves, eye, head and neck protection, and footwear appropriate for the job.
• Keep dry socks, gloves, hats, jackets and other items on hand in case a change is needed.
• Avoid touching cold metal surfaces with bare skin.
• Stay well nourished by snacking on energy-rich foods.
• Immediately report signs and symptoms of cold stress.
• Take frequent breaks in a safe, warm location to warm up and rehydrate.

Radiant heaters can be used in outdoor security stations where there is protection from drafts or wind. As the body works to stay warm, there is a higher likelihood of becoming dehydrated in cold weather. Fresh water and warm beverages should be available. As feasible, heavy work should be scheduled during the warmest part of the day.

New employees and those returning after time away from work should be given time to adapt to the cold by gradually increasing their workload and scheduling more frequent breaks in warm areas. Contrary to popular belief, blood does not become thicker and improves resistance to cold when an employee moves from a warmer climate to a colder one.

A buddy system is also imperative to keep employees safe. Workers should be assigned tasks in pairs so they can monitor each other for signs of cold stress.

To learn more about keeping your employees safe during the cold winter months, visit us at www.workcare.com.