Tips for Cold Stress Safety and Protection

Prevent serious injuries and illnesses on the jobsite.
By Mark S. Williams
December 5, 2022

The best time to think about cold stress safety isn’t when it’s about to snow—it’s when it’s still warm out. Cold stress happens when skin temperature and internal body temperature drops. If the body can’t warm itself, the stress can lead to serious illnesses and injuries.

Construction firms and other businesses may start to think about protecting workers against the cold when frigid temperatures and the winter are right around the corner. Oftentimes though, that may be too late. When a person’s body temperature becomes too low, it can affect their brain function and ability to move. Illnesses and conditions brought on by cold stress can also cause permanent damage in a person’s body. It’s an issue that needs to be taken seriously and can lead to serious health problems if left unchecked. Like planning for temporary heat or building temporary enclosures, possible solutions for cold-related risks require very specific planning, equipment and materials, so it’s never too soon to begin a cold stress protection strategy to prevent serious injuries and illnesses on the jobsite.

A common misconception is that cold stress can only happen when someone is outside, but workers face risks indoors and outdoors. They can occur in any industry where workers are exposed to the cold, including construction.

If a building isn’t insulated adequately, it won’t provide warmth or protection from cold elements. In the construction industry, workers may be at jobsites working inside partially constructed buildings and exposed to the cold. This is a unique risk present in the construction industry that firms need to address if they’re working in the winter.

A worker’s physical fitness and condition are also important cold stress risk factors. Poor levels of conditioning can result in faster core temperature cooling, and pre-existing conditions such as a prior diagnosis of frostbite, Raynaud’s phenomenon, peripheral vascular disease and diabetes can further accelerate the risk of injury.

What Are the Symptoms of Cold Stress?

Cold stress symptoms vary depending on the injury or illness. While there are some common symptoms across different cold stress-related injuries and illnesses, each can affect the body differently. Some common injuries that cold stress can cause include hypothermia, frostbite, trench foot and chilblains.

When it comes to hypothermia, which can affect brain function and make a person unable to think clearly or move well, there are varying levels of severity, according to “Cold Stress – Cold-Related Illnesses” from the U.S. Centers for Disease Control and Prevention. Mild hypothermia occurs when a person’s body temperature is between 90º and 98º, and symptoms include shivering, lack of coordination, stumbling, slurred speech and pale skin. There is also moderate hypothermia, which occurs when body temperature is between 86º and 90º. At this stage, shivering stops, but there is reduced breathing and a slower heart rate. A person may be unable to stand or walk and appear confused or irrational.

Hypothermia becomes severe when body temperature is between 78º and 86º, and a person experiences muscle stiffness and an irregular pulse. This is the most concerning level of seriousness as a person can also be very sleepy and have extremely cold skin.

When a person has frostbite, they lose feeling and color in the impacted area. It commonly affects a person’s nose, ears, cheeks, chin, fingers and toes, damaging deeper tissues of the body. Symptoms include reduced blood flow to the hands, feet, fingers or toes, causing numbness, tingling or aching.

Meanwhile, trench foot, also known as immersion foot, results from prolonged exposure to wet and cold. It doesn’t technically need to be frigid outside for someone to suffer from trench foot. In fact, it can happen at temperatures as high as 60º if the feet are wet, and symptoms include skin reddening, numbness, leg cramps, swelling, blisters or ulcers, bleeding under the skin and gangrene.

Chilblains, which is the inflammation of the small blood vessels in the skin due to repeated cold exposure, can cause permanent skin damage and redness. If someone is repeatedly exposed to cold temperatures, the itchiness can return with additional exposure. Symptoms include redness, itching, blistering, inflammation and ulceration.

How to Help Employees Get Rid of Cold Stress?

To reduce injury and illness risk, workers need protection from cold exposure. Construction companies can take measures to protect against cold stress by providing appropriate personal protective equipment (PPE) such as windbreakers, hats, gloves and boots for working in a cold environment. In addition, they can train supervisors and workers to prevent, recognize and treat cold-related illness and injury, as well as properly monitor jobsites in cold conditions to make sure workers are taking adequate breaks in a warm environment.

The imperative, though, is that construction companies provide prompt medical attention if workers show signs of cold-related illness or injury. Creating a management and employee safety committee would be helpful and providing risk management solutions before a situation arises. This includes mitigation efforts such as encouraging breaks to warm up when needed and ensuring access to warm areas to change out of wet clothes, as well as reducing workers’ time spent in cold environments and rotating workers to provide relief from the physical demands of a construction job.

by Mark S. Williams
Dr. Mark S. Williams is a chiropractic physician and medical director with The Hartford. He received his Doctor of Chiropractic from Logan College of Chiropractic, his MBA from the University of Southern Maine, and a bachelor’s degree in Human Biology from Logan College of Chiropractic. He is board certified in occupational health and applied ergonomics. The Hartford offers middle and large commercial contractors injury prevention services (IPS), which includes onsite and virtual services.

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