With extreme cold spreading across a large section of the U.S., the National Institute for Occupational Safety and Health (NIOSH) is reminding workers whose job requires them to work outdoors in cold, wet, icy, or snowy conditions to “be prepared and be aware” to prevent cold-related illnesses and injuries such as hypothermia and frostbite.

“Exposure to cold is not just uncomfortable, it can be a potentially dangerous situation,” said NIOSH Director John Howard, MD. “It’s important to know how to protect yourself from cold when you must work outdoors—be prepared by wearing warm clothing and be aware that cold temperatures can lead to serious health problems.”

Who is at risk?

Anyone who has to work in a cold environment may be at risk of cold-related illnesses and injuries, or “cold stress.” Workers who may not be able to avoid working outdoors in cold weather could include police officers, snow cleanup crews, sanitation workers, farmers, construction workers, and many others. Workers face increased risks when they take certain medications, are in poor physical condition or suffer from illnesses such as diabetes, high blood pressure, or heart disease.

For outdoor workers, what constitutes cold stress and its effects can vary across different parts of the country. In regions where workers are unaccustomed to winter weather, near freezing temperatures are considered factors for cold stress. Whenever outdoor temperatures drop significantly below normal and wind speed increases, heat more rapidly leaves the body.

Protect yourself: Be prepared and be aware

When cold environments cannot be avoided, workers should follow these recommendations to protect themselves from cold stress:

Be prepared by wearing warm clothing that is right for the weather

• Wear several layers of loose clothing; layering provides better insulation.
• Protect your ears, face, hands, and feet by wearing a hat and waterproof gloves and boots.
• Carry cold weather gear, such as extra socks, gloves, hats, jacket, blankets, a change of clothes and a thermos of hot liquid.

Be prepared to limit time spent outdoors

• Take breaks in warm locations, such as inside a vehicle or other sheltered or heated area.
• Workers may also need to limit their time outside on extremely cold days, so cold jobs should be scheduled for the warmest part of the day and relief workers may need to be assigned for long jobs.

Be aware that cold temperatures can lead to illness and injury

• Pay attention to warning signs and symptoms of hypothermia, frostbite, and other cold-related illnesses and injuries.
• Monitor your physical condition and that of your coworkers.
• Immediately report signs and symptoms of cold-related illnesses and injuries to a supervisor or medical personnel.
• Tell your supervisor if you are not dressed warmly enough.

Cold-related illnesses and injuries

These weather-related conditions may lead to serious health problems:

Hypothermia

• When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature.
• Early symptoms of hypothermia include shivering, fatigue, loss of coordination, confusion, or disorientation.
• Hypothermia affects the brain, making the victim unable to think clearly or move well.
• Work with a buddy when possible.

Frostbite

• Many parts of the body are prone to frostbite, including your fingers, toes, nose, and ears. Frostbite happens when a part of the body freezes, damaging the tissue.
• Warning signs of frostbite include numbness or tingling, stinging, or pain on or near the affected body part.
• Avoid frostbite by being aware of the weather and wearing protective clothing such as warm gloves, insulated shoes, and warm hats.

Trench foot

• You can get trench foot when your feet are wet and cold for too long. Moisture causes your feet to lose heat, and this can slow the blood flow and damage tissue.
• Trench foot can happen when it is as warm as 60 degrees.
• Keep feet warm and dry.

Resources

The following resources can help you learn more about staying safe when working in cold:

• NIOSH Fast Facts card, “Protecting Yourself from Cold Stress,” provides information about cold stress at work including first aid instructions. This free resource is designed for individuals and for employers to share with their employees.
• CDC podcast, “Working in Cold.” Learn how to identify symptoms that tell you there may be a problem and protect yourself from cold stress.
• CDC infographic, “Avoid, Spot, Treat Hypothermia and Frostbite.”
• For more information on cold stress including cold-related illnesses and injuries, recommendations, and additional resources, visit the NIOSH web page on cold stress.
• NIOSH is the federal institute that conducts research and makes recommendations for preventing work-related injuries, illnesses and deaths. For more information about NIOSH, visit www.cdc.gov/niosh/.
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