Anyone working in a cold environment may be at risk for cold stress, whether outdoors in construction or agriculture or indoors in refrigerated warehouses and cold storage facilities. Prolonged exposure to cold temperatures, especially when combined with wind or wet conditions, can lead to serious health problems, including hypothermia, frostbite, and trench foot. In severe cases, cold stress can be fatal.
Although OSHA does not have a specific standard for working in cold environments, employers are responsible for protecting workers from recognized cold stress hazards that could cause serious injury or death under the Occupational Safety and Health Act.
Common Types of Cold Stress
Workers should understand the different types of cold stress, recognize the warning signs, and know how to respond before a condition becomes life-threatening.
Hypothermia
Hypothermia occurs when the body's core temperature drops below 95°F because it loses heat faster than it can produce it. Although typically associated with freezing conditions, hypothermia can also occur at temperatures above 40°F, especially when a person is wet from rain, sweat, or cold water.
Symptoms: Uncontrollable shivering, confusion, loss of coordination, slurred speech, drowsiness, and extreme fatigue.
First Aid: Call for emergency medical assistance. Move the worker to a warm, dry location, remove wet clothing, and wrap them in dry blankets or clothing. Focus on warming the center of the body, including the chest, neck, and head. Handle the person gently and stay with them until medical help arrives.
Frostbite
Frostbite occurs when skin and underlying tissues freeze, potentially causing permanent tissue damage or amputation. It most commonly affects exposed or poorly protected areas such as the fingers, toes, nose, ears, and cheeks. Wind and moisture can increase the risk by accelerating heat loss.
Symptoms: Numbness, tingling, skin that appears pale, white, or grayish-yellow, hard or waxy skin, and possible blistering.
First Aid: Move the worker to a warm location and seek medical attention promptly. Protect the affected area with a loose, dry dressing. Do not rub or massage frostbitten skin, break blisters, or apply direct heat. Avoid walking on frostbitten feet or toes. Rewarming should be performed carefully when refreezing can be prevented, preferably under medical supervision.
Trench Foot
Trench foot is a cold-related injury caused by prolonged exposure to wet conditions. It can develop even when temperatures are as high as 60°F if feet remain wet for extended periods. Wet feet lose heat much faster than dry feet, increasing the risk of tissue damage.
Symptoms: Tingling, numbness, pain, swelling, cramps, redness or discoloration, and blisters.
First Aid: Remove wet boots and socks, gently clean and dry the feet, and move the worker to a warm environment. Elevate the feet and avoid unnecessary walking. Seek medical attention for evaluation and treatment.
Preventing Cold Stress
Cold stress injuries can develop gradually, and workers may not immediately recognize that they are in danger. Dress in appropriate layers, keep clothing and footwear dry, take regular breaks in warm areas, and monitor yourself and co-workers for warning signs.
Recognizing symptoms early and taking prompt action can prevent serious complications. Never ignore signs of cold stress or allow an affected worker to continue working in dangerous conditions.
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