While OSHA standards require employers to protect workers from risks stemming from fall protection, there is no OSHA requirement for employers to provide workers with ordinary clothing, skin creams, or other items, used solely for protection from weather. Still, employers should take steps to protect employees against injuries and illnesses as a result of extreme temperatures. Here are eight pieces of PPE that could help prevent cold stress among outdoor workers.

1. Hard Hat Liner/Head Covering
A hard hat liner or head covering should not impair the fit of other protective equipment. A balaclava could be a viable option for preventing heat escape from the head while also covering the face and ears.

2. Eye Protection
Ultraviolet or UV ray protection equally is important in the winter as it is in the summer because as the sun's rays reflect off snow.

3. Mouth/Face Covering
A mouth or face covering not only protects against the cold but wind burn as well.

4. Outer Layer
An effective outer layer will assist with protecting a worker against the cold and precipitation. In addition, it should be reflective and brightly colored.

5. Middle Layer
The middle layer should provide insulation even when wet. Wool, polypropylene or synthetic blends will provide protection as well as ventilation.

6. Bottom Layer
The layer closest to the body should be moisture-wicking. Common materials include synthetics such as polypropylene or a polyester/spandex blend.

7. Gloves
Gloves should have a dual purpose: to insulate from the elements while providing protection against job-specific risks such as cuts. In addition, they still should have an appropriate level of dexterity for the job task.

8. Boots – Insulated, Waterproof and Studded
Keeping dry during cold weather is key, and this includes the extremities. Boots should be insulated and waterproof and also should provide traction to reduce the instance of slips, trips and falls.

Preventing Cold Stress

Donald Garvey, construction technical specialist at 3M, spoke about the importance of protecting workers against heat and cold stress at ASSE's Safety 2016.

"The fact of the matter is, no one talks about cold stress," he said.
Just as with heat stress, there is an acclimation period of about 10 days, and most cold-related injuries occur within that time.

Early warning signs of cold stress include shivering, fatigue and possibly dehydration. More serious conditions are first signaled with severe shivering and pain in the extremities.

As body temperature drops, blood moves internally to protect vital organs. So, warming the center of the body first is crucial so those organs are protected. Likewise, if a worker is conscious, warm beverages are appropriate. However, if no pulse is detected, CPR must begin and continue until emergency medical services arrive.

A worker experiencing severe symptoms should be removed immediately from the conditions. If a worker stops shivering and has bluish skin, medical attention must be sought before hypothermia sets in.

To prevent dehydration, regular, timed drinks should be encouraged since a worker is not able to distinguish how thirsty they really are in extreme conditions, Garvey recommended.

The factors contributing to frostbite, a common cold condition, also can be avoided. 

Inadequate clothing, inactivity and direct contact with cold metal are all things employers should look out for, he said.

Garvey emphasized the importance of proper clothing, including wearing waterproof, insulated, loose fitting boots and clean socks.

"Keeping your feet clean and dry is important," Garvey said. "Oils and dirt affect insulation ability."

In addition, multiple layers are imperative. Each layer should have a different function for the most effectiveness.

Balancing high-and-low intensity work also will lower the risk of cold stress.

"You don't want the worker to get worked up and sweaty in cold conditions," Garvey said.

Lastly, having a buddy system to recognize warning signs also should be implemented.