Cold Weather Concerns - Frostbite and Hypothermia

Winter is coming, and prepping workers for cold temperatures should start well before the first snowflakes and ice storms occur. Proper PPE should include multiple layers of protection, both moisture wicking and wind resistant, as well as gloves and hard hat liners.

Dressing improperly, wetness/dampness and preexisting conditions can contribute to cold stress, hypothermia, and frostbite - conditions that occur when the body’s temperature begins to fall to dangerous levels (below 95 degrees F), resulting in tissue damage and even death.

Humidity, wind speed, and air temperature should all be taken into account. According to the Centers for Disease Control (CDC), when air temperature is 40 degrees F, the wind speed is 35 mph, and humidity levels are above 50%, the effect on exposed skin is as if the air temperature were in the 20s. 

• If a worker is showing signs of hypothermia, the CDC recommends the following steps:

• Call 911 immediately in an emergency; otherwise seek medical assistance as soon as possible.

• Move the person to a warm, dry place.

• Remove wet clothes and replace with dry clothes, cover the victim with layers of blankets (including the head and neck), and with a vapor barrier (tarp or trash bags will work). Do not cover the face.

• If medical help is more than 30 minutes away:

  • Give warm sweet liquids to a fully conscious victim (no alcohol) to increase internal body temperature. Never attempt to give an unconscious person fluids.

  • Place warm bottles or hot packs at the armpits, sides, chest, and groin areas.

• If a person is not breathing or has no pulse:

  • Call 911 immediately.

  • Be very careful and gentle with victim, treat them for hypothermia as listed above.

  • Check the victim for signs of breathing and/or pulse continuously for 60 seconds.

  • If victim has no pulse or is not breathing after 60 seconds start rescue breaths for 3 minutes.

  • Recheck breathing and pulse for 60 seconds.

  • If the victim is still not breathing and has no pulse continue rescue breathing.

  • Only start chest compression per direction of a 911 operator or emergency medical technician.

  • Reassess victim’s physical status periodically.

Recognizing the symptoms of hypothermia could prevent worker injuries or death.

• Signs of Hypothermia

  • Shivering - Shivering is a sign of mild hypothermia. As the body’s temperature drops further and hypothermia becomes more severe, shivering will decrease or cease completely.

  • Faster Breathing - Breathing will begin fast but will slow and finally stop as hypothermia progresses to later stages.

  • Confusion - As a body’s core temperature drops, poor decision-making will increase along with confusion and delirium. A worker may try to remove clothing thinking it will solve the problem.

  • Trouble Speaking - Slurred speech and mumbling will accompany other hypothermia symptoms as severity increases.

  • Dizziness and lack of coordination - Working at heights is inherently dangerous, and as temperatures drop, cold could affect a worker’s balance. As the body tries to adjust, stumbling and difficulty handling objects will probably occur.

  • Fatigue - As a worker’s performance begins to fail, they will become increasingly drowsy, eliciting complaints of fatigue and yawning frequently. 

  •  Rapid Heart Rate/Pulse - In the beginning a worker’s heart rate will speed up, however as hypothermia sets in their pulse will slow down considerably.

  • Hunger and Nausea - Initially a worker may complain of hunger. However, as the core temperature drops, the body will be more focused on keeping vital organs alive and become apathetic to hunger and nausea.

• Frostbite First Aid
  When exposed to very cold, wet, windy conditions, skin and underlying tissues can freeze, resulting in frostbite. The areas most susceptible to frostbite are fingers, toes, nose, ears, cheeks, and chin. 

  If your skin pales, or turns red and is very cold, hard or waxy looking, you may have frostbite. You will probably also experience a prickling feeling or numbness. With severe or deep frostbite, you may experience blistering and pain.

  You can treat very mild frostbite (known as frostnip) with first-aid measures, but more severe frostbite requires medical attention. First-aid for frostbite is as follows:

  • Check for hypothermia – Get emergency medical help if you suspect hypothermia (see symptoms above).

  • Protect your skin from further exposure. Warm hands by tucking them into your armpits. Protect your face, nose, ears by wearing a stocking face mask or covering them with gloved hands. Don’t rub the affected area and never rub snow on frostbitten skin.

  • Get out of the cold. Once you are indoors remove wet clothing.

  • Gently rewarm frostbitten areas. Soak hands and feet in warm water (99-106 degrees) for 15-30 minutes. If a thermometer isn’t available, test the water by placing an uninjured elbow in it – it should feel very warm, but not hot. Don’t rewarm frostbitten skin with direct heat such as a stove, heat lamp, heating pad, or fireplace. This can cause burns and blisters.

  • If there is any chance the affected areas will freeze again, don’t thaw them. If they’re already thawed, wrap them up so they don’t refreeze.

  • Don’t walk on frostbitten feet or toes if possible. Further damage can occur to tissues.
    Know what to expect as skin thaws. If the skin turns red and you feel tingling and burning as it warms, normal blood flow is returning. Seek medical attention if numbness or pain persists during warming or if blisters develop.

Contact OMAG Risk Management Services if you have questions about this or any other worker safety topic.  Kip Prichard can be reached at (800) 234-9461 or kprichard@omag.org.