Keeping the Chill Out: Working Safe in Cold Weather

It is best to get to a warm place where the employee can stay dry and warm after re-warming the body part(s). Use warm (100 F/38 C), not hot, water for 30-45 minutes until a good “flush” or reddening of color has returned to the skin. Do not place affected extremities near a fire. It can cause burns due to the lack of sensation in the affected area. You can place affected areas under the armpits or groin area for re-warming as well.

Once an area is re-warmed, it is imperative to keep the area from re-freezing. If re-freezing occurs, this is very serious and can cause permanent damage. It is better to delay warming if there is a chance the area can refreeze while trying to make it to permanent shelter.

Do not thaw the injury with melted snow or ice. Do not rub the area with snow. Finally, avoid alcohol, nicotine and other drugs that can further restrict the blood flow to the affected area.

In summary, frostbite is a serious condition that can be prevented if you plan ahead, properly train the employees in recognizing signs and symptoms and the employees know the appropriate clothing and fabric to wear.

HYPOTHERMIA

Hypothermia is a dangerously low body temperature. It occurs when more heat is lost than the body can generate. It usually is caused by extended exposure to the cold. Hypothermia can kill amazingly fast when cold temperatures and strong winds cause the body to quickly lose heat. Symptoms of hypothermia start with shivering, which is the body's attempt to heat from rapid muscular shaking. When the body's temperature drops to below 95 F/35 C, shivering stops and dizziness and disorientation begin.

At this point, the body only maintains heat around its vital organs — brain, heart and lungs — and shuts down circulation to the arms and legs. The heart rate becomes slow, intermittent and weak, and the blood vessels widen. This makes a person feel hot and want to remove all of his clothes before he finally slips into unconsciousness. Ultimately, the heart stops.

The risk of hypothermia is significantly higher when temperatures are below freezing, although anything that is below body temperature (98.6 F/37 C) can explain hypothermia, especially in older employees.

Employees who are wearing inappropriate clothing are at higher risk for hyphothermia, as are employees who are wet, tired, dehydrated or suffering from malnutrition. The risk of hypothermia is greater if alcohol is consumed, because alcohol makes blood vessels dilate, providing a larger surface area through which heat can be lost.

As with frostbite, it is easier to prevent hypothermia than it is to treat it. It is important to have everyone working outdoors trained in the recognition of symptoms. If a supervisor or coworker suspects a person might have symptoms of hypothermia, a rapid response could save a life.

Symptoms of mild hypothermia include a core temperature between normal and 96 F/35.5 C, involuntary shivering and the inability to do things requiring motor skills. Moderate hypothermia means a core temperature between 95 F/35 C and 93 F/33 C. Symptoms include confused thought processing, loss of general motor control, slurred speech, aggressive shivering and, finally, the perception that the person feels hot.

Severe hypothermia rapidly can cause death. The core temperature is between 92 F/33 C and 86 F/30 C. The person has a pale, whitish skin tone and dilated pupils. Waves of aggressive shivering are followed by pauses, which get longer until the shivering finally stops. At this point, the body recognizes that it is not creating enough heat and chooses to retain the energy instead.

The body goes into hibernation and the worker will appear dead, although he actually might still be alive. In cases of fatal hypothermia, the core temperature falls below 86 F/30 C, breathing becomes erratic, the person becomes unconscious and the heart stops.

ASSESSING/TREATING HYPOTHERMIA

There are ways to assess the stages of hypothermia:

• Ask the employee to stop shivering. If he can, then hypothermia most likely is mild.
• Ask the employee a mathematical question. If he can do it, then hypothermia is most likely mild.
• If you can't find a pulse at the person's wrist, then this can be a sign of a core temperature of less than 90 F/32 C, indicating severe hypothermia.
• If the employee is in a fetal position, try to open his arms. If they curl back then the person still is alive, because dead muscles will not contract.